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The effect of different estradiol levels on carotid artery distensibility during a long agonist IVF protocol

Authors
  • Leppänen, Jonna1
  • Randell, Kaisa2
  • Schwab, Ursula3, 4
  • Pihlajamäki, Jussi3, 4
  • Keski-Nisula, Leea1
  • Laitinen, Tomi5
  • Heinonen, Seppo2
  • 1 Kuopio University Hospital and University of Eastern Finland, Puijonlaaksontie 2, Kuopio, FIN-70210, Finland , Kuopio (Finland)
  • 2 University of Helsinki and Helsinki University Hospital, Helsinki, HUS 00029, Finland , Helsinki (Finland)
  • 3 University of Eastern Finland, Kuopio, Finland , Kuopio (Finland)
  • 4 Kuopio University Hospital, Kuopio, Finland , Kuopio (Finland)
  • 5 Kuopio University Hospital and University of Eastern Finland, Kuopio, FIN-70210, Finland , Kuopio (Finland)
Type
Published Article
Journal
Reproductive Biology and Endocrinology
Publisher
Springer (Biomed Central Ltd.)
Publication Date
May 12, 2020
Volume
18
Issue
1
Identifiers
DOI: 10.1186/s12958-020-00608-w
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThis study was made to figure out, does low and high estradiol levels during in vitro fertilization (IVF) cycles have a different effect on carotid artery distensibility (Cdis), carotid artery diameter (Cdia), blood pressure and metabolic factors? Can the stimulation protocol be considered safe to women’s vasculature?MethodsWe studied 28 women having a long agonist protocol IVF-treatment in Kuopio University Hospital during the years 2011–2016. Patients were examined at three time points: in the beginning of their own period (low estradiol), during the gonadotrophin releasing hormone (GnRH) analogue downregulation (low estradiol) and during the follicle stimulating hormone (FSH) stimulation (high estradiol). Women served as their own controls and their menstrual phase (2- to 5-day period after the beginning of menstruation with low estrogen) was used as the reference. Cdis and Cdia were assessed using ultrasound. Blood pressure, weight, estradiol levels and lipids were monitored.ResultsCdis, Cdia, systolic and diastolic blood pressures peaked during the GnRH-analogue treatment with the lowest estradiol levels. Cdis, Cdia and systolic blood pressures declined by 11% (P = 0.002), 3,8% (P < 0.001) and 2,5% (P = 0.026) during the FSH-stimulation when the estradiol levels were high. Cdis correlated significantly (P < 0.05) with systolic blood pressure, diastolic blood pressure and triglycerides in high estrogenic environment and with diastolic blood pressure (P < 0.05) when estrogen profiles were low.ConclusionsCarotid artery stiffens during the high estradiol levels compared to low levels and this was not explained by the higher diameter of the carotid artery, hyperlipidemia or blood pressure profiles. All the changes in Cdis and Cdia are variations of normal, and if there is no history of cardiovascular problems, it can be considered, that the stimulation protocol is not hazardous to vasculature.

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