Impact of Supraphysiological Estradiol on ECG in IVF Patients

Konya City Hospital62 enrolled

Overview

This prospective observational study aimed to evaluate the effects of supraphysiological estradiol (E2) levels, induced by gonadotropin therapy during IVF, on cardiac electrophysiological parameters. Sixty-two women aged 18-40 undergoing IVF treatment at Konya City Hospital between December 2024 and January 2025 were included. ECG recordings were performed twice: once before gonadotropin stimulation and again on the day of hCG administration, when peak E2 levels were expected. Routine blood tests and hormone levels were also evaluated. Patients with obesity, cardiovascular disease, chronic illness, or medication use were excluded. After treatment, significant increases were observed in PR interval, J-Tpeak, QTc, and Tp-e values. E2 changes showed a moderate negative correlation with QTc and a low positive correlation with J-Tpeak. The results suggest that elevated E2 levels during IVF may affect cardiac electrophysiology, highlighting the need for careful monitoring in women with cardiac risk factors.

Study Type

OBSERVATIONAL

Enrollment

Conditions

In Vitro Fertilization Estradiol Cardiac Electrophysiology Electrocardiography (ECG)Reproductive Endocrinology

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 40 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Female patients aged 18 to 40 years Undergoing IVF treatment at Konya City Hospital between December 2024 and January 2025 No cardiac pathology based on cardiology consultation Eligible for controlled ovarian stimulation using a short antagonist protocol Provided informed consent Exclusion Criteria: \- Age under 18 or over 40 years Baseline estradiol level \> 50 ng/L on day 2 of menstrual cycle Presence of any known chronic diseases (e.g., diabetes mellitus, hypertension, rheumatologic disorders, thyroid disorders) Use of any medications other than those used for IVF Current smoker or alcohol user Family history of cardiac disease or sudden cardiac death Personal history of myocardial infarction, angina, heart failure, or any structural heart disease History of cardiac surgery or coronary intervention

Outcomes

Primary Outcomes

Change in QTc Interval Before and After Gonadotropin-Induced Estradiol Elevation

QTc interval will be measured via 12-lead electrocardiography (ECG) at two timepoints: (1) on menstrual cycle day 2-3 prior to gonadotropin stimulation (baseline), and (2) on the day of hCG administration when estradiol reaches peak levels. The difference between pre- and post-treatment QTc values will be calculated.

Time frame: Approximately 8-12 days from baseline to post-treatment ECG

Secondary Outcomes

Change in PR Interval Following Gonadotropin-Induced Estradiol Elevation

PR interval will be assessed using standard 12-lead ECG both before and after gonadotropin stimulation. Measurements will be taken on menstrual day 2-3 and again on the day of hCG administration to evaluate PR interval prolongation in response to elevated estradiol levels.

Time frame: Approximately 8-12 days