Adverse perinatal outcome and in vitro fertilization singleton pregnancies: what lies beneath? Further evidence to support an underlying role of the modifiable hormonal milieu in in vitro fertilization stimulation

The author discusses the need to identify methods to minimize risk in IVF conceptions.


Suleena Kansal Kalra, M.D., M.S.C.E.

Vol 97, Issue 6 , Pages 1295-1296


The findings reported by Imudia et al. (1) contribute to the emerging body of literature identifying modifiable aspects of IVF treatment that are associated with risk in singleton births. The most novel aspect of this study is that it presents a "threshold" effect of supraphysiologic E2 levels and subsequent antenatal and perinatal adverse outcome. In this study, outcomes were assessed in a group of patients undergoing IVF treatment and exposed to an elevated peak E2 level at a single institution, defined as an E2 level exceeding the 90th percentile on the day of hCG administration (>3,950 pg/mL), and compared to a group of patients undergoing IVF treatment with levels of E2 below that cutoff.

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