Objective To investigate whether supraphysiological estradiol (E2) in controlled ovarian stimulation (COS) cycles affects the subsequent frozen‐thawed embryo transfer (FET) in terms of the neonatal birthweight. Design Retrospective cohort study. Setting University affiliated hospital. Population In all, 2066 patients undergoing FET cycles that resulted in live singleton births between July 2011 and Dec 2016. Interventions None. Methods Multivariable linear regression and logistic regression was used to evaluate the association between peak E2 and birthweight outcomes. Main outcome measures Birthweight, z‐score adjusted for gender and gestational age, and incidence of small‐for‐gestational‐age (SGA) and low birthweight (LBW) in singleton neonates derived from FET cycles. Results Adjusted for confounding factors, both the absolute birthweight and the z‐score of singletons following FET were negatively associated with peak E2 levels in COS. In comparison with the referent category (E2 ≤1500 pg/ml), the categories with E2 >3000 pg/ml had a significantly lower z‐score. The difference (95% CI) in estimated marginal mean of birthweights between referent category and highest E2 (>8000 pg/ml) category was 104.57 g (18.13–181.06). Multiple logistic regression analyses showed that the adjusted odds ratio (95% CI) for SGA and LBW in term singletons comparing patients with E2 >3000 pg/ml with those with E2 ≤3000 pg/ml was 2.44 (1.37–4.34) and 2.32 (1.01–5.40), respectively. Conclusions Peak E2 levels in COS cycles are negatively associated with the birthweight of singletons conceived through subsequent FET cycles. Tweetable abstract The birthweight following FET is affected by previous COS cycle.

Objective To investigate the association between body mass index (BMI) and ectopic pregnancy (EP) following embryo transfer (ET).Design Retrospective cohort study.Setting University-affiliated hospital.

Background Grading of endoscopic lesions is important for determining the severity of ulcerative colitis and developing treatment strategies, but the commonly used methods are not sufficient.This study aimed to investigate whether new endoscopic scoring systems incorporating lesions and disease extent are associated with clinical disease severity and maintainable remission. Methods This was a retrospective study. One hundred and ten patients with ulcerative colitis were included and eighty seven completed 12 months follow-up.Colonoscopy was performed within 1week before blood samples were taken. DUBLIN (Degree of ulcerative colitis burden of luminal inflammation) scores were calculated as the product of MES (Mayo endoscopic score) by disease extent and UCEIS (ulcerative colitis endoscopic index of severity) was used to replace MES when calculating modified DUBLIN scores. Results DUBLIN and modified DUBLIN scores were increased in the moderate and severe groups significantly (p<0.05). Both of increased scores contributed to the detection of serious diseases, and the clinical cut-off values of DUBLIN and modified DUBLIN were 3(AUC=0.809, p=0.001) and 7(AUC=0.815, p=0.001). They were with high sensitivity, but the specificity of DUBLIN was lower. Both scores were correlated to partial Mayo scores, CPR and ESR positively, and they were correlated to the albumin negatively (p<0.05). Higher modified DUBLIN scores (>7) were associated with an increase risk of treatment failure (HR=4.96, 95% CI 1.17-21.00, p=0.03), but there were no association between DUBLIN scores and long term remission (p>0.05). Conclusion Increased DUBLIN and modified DUBLIN scores were conducive to screening serious disease, but only modified DUBLIN scores had the potential to assist in making an upgraded therapeutic schedule.