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Correlation between steroid hormonal levels and cardiac function in women during controlled ovarian hyperstimulation

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Abstract

During in vitro fertilization-embryo transfer (IVF-ET) treatment, most women require controlled ovarian hyperstimulation (COH). COH with gonadotropins results in an increase in steroid hormonal levels; however, it is unclear what impact these high concentrations of steroid hormones have on cardiac heart function. The purpose of this study was to examine the effect of high levels of estradiol (E2) and progesterone (P) during COH treatment on cardiac function in women undergoing IVF-ET. A total of 34 women with infertility due to tubal or male factors treated with COH and 28 women with normal menstrual cycles who underwent ovulation monitoring only were enrolled in this study. The serum levels of steroid hormones and the parameters of echocardiography at different time points during the natural menstrual cycles of the control group and the corresponding time points during COH treatment of the study group were compared. The independent sample with the t test, the paired sample with t test, χ 2 test, and Pearson correlation analysis were applied. The steroid hormonal levels were significantly different between natural menstrual cycles and COH treatment cycles. Left ventricular end-diastolic volume (LVEDV) reached the highest level on day 7 after oocyte pickup; in contrast, ejection fraction (LVEF) was the lowest level on the same day. On day 16 after ET, E2 and P levels were maintained in the pregnant women in the study group; however, the levels of those hormones returned to those of a natural menstrual cycle in non-pregnant women. The parameters of LVEF and LVEDV significantly correlated with E2 concentrations. High levels of E2 during COH treatment may temporarily affect cardiac function, suggesting that COH intervention is relatively safe; however, a certain level of risk might exist.

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Acknowledgments

The authors are grateful to Professor Ri-Cheng Chian at Department of Obstetrics and Gynecology, McGill University, Montreal, Canada for his help to revise this manuscript. We thank Yi Zhou and Yan Zhao for helpful suggestions on the manuscript. We also thank Xiaoyan Wang, Lei Gao, Zhaojin Du, and other members of reproductive center for their support of this study. This study was supported by Qingdao Municipal Science and Technology Commission.

Conflict of interest

The authors declare that there is no any conflict of interest.

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Authors and Affiliations

  1. Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750004, Ningxia, China

    Yiran Li & Jichun Li

  2. Laboratory of Echocardiography, Qingdao Municipal Hospital, 5 of Donghai Road, Qingdao, China

    Xiuhua Sun

  3. Center for Reproductive Medicine, Qingdao Women and Children Hospital, 217 of Liaoyang Western Road, Qingdao, China

    Lili Zang, Quan Zhang & Shuhua Zou

  4. Ocean University of China, 5 of Yushan Road, Qingdao, China

    Shuhua Zou

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  1. Yiran Li
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  2. Xiuhua Sun
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  3. Lili Zang
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  4. Quan Zhang
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  5. Jichun Li
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Correspondence to Shuhua Zou.

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Supplementary Fig. 1

Cardiac structure indexes of the two groups. PAd pulmonary artery diameter, AOd aortic diameter, RAd right atrial diameter, LAd left atrial anteroposterior diameter, RVd right ventricular anteroposterior diameter, LVd left ventricular diameter, LVs left ventricular and end-systolic diameter, LVsd interventricular septum diastolic thickness, PWd left ventricular end-diastolic wall thickness (DOC 44 kb)

Supplementary Table 1

Parameters measured by Doppler echocardiography. Vs peak systolic forward aortic blood flow velocity, Vpa the maximum peak velocity of pulmonary blood flow, SBP systolic blood pressure, DBP diastolic blood pressure (DOC 37 kb)

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Li, Y., Sun, X., Zang, L. et al. Correlation between steroid hormonal levels and cardiac function in women during controlled ovarian hyperstimulation. Endocrine 44, 784–789 (2013). https://doi.org/10.1007/s12020-013-9953-7

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  • DOI: https://doi.org/10.1007/s12020-013-9953-7

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