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

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.