The Impact On The Function Of Pancreatic Islets After Exposure To High Estradiol Environment During The First Trimester Of Pregnancy

Objective:To investigate whether the high estradiol (E2) environment in the first trimester would increase the risk of endocrine pancreatic dysfunction in the children after in vitro fertilization and fresh embryo transfer (IVF-ET).Methods:A retrospective review was performed on561children whose age is from3-6years old about family history, maternal and birth characteristics, current weight and height, blood pressure, serum insulin and glucose. We divided them into groups as follows: born after fresh embryo transfer (ET)(n=261), frozen embryo transfer (FET)(n=160) and natural conception singletons (NC)(n=140). Meanwhile, we studied another137newborns, including44after IVF-ET,43after IVF-FET and50after natural conception. We also investigate379pregnant women to prove the maternal high estradiol environment through IVF-ET.Result:Women accepted fresh ET undergo a supra-physiological E2level, compared with women accepted frozen ET and women with NC (P<0.05). Although there is no significant difference in fasting glucose in newborns among three groups, fasting insulin level is much higher in ET group than the other two groups. Also, HOMA-IR score is higher in ET group than the other two. The same tendency was confirmed in children. Furthermore, fasting plasma glucose-to-insulin ratio of fetus in ET group positively correlated with maternal serum levels of E2during early pregnancy.Conclusion:Exposure to high E2environment during the first trimester of pregnancy increases the risk of endocrine pancreatic dysfunction. Frozen ET which could prevent the happening of high E2environment can reduce the risk of pancreas damage in children conceived by IVF.