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This study's objectives were to compare the clinical, perinatal, and obstetrical outcomes of patients with different estradiol (E ) levels in fresh single-blastocyst-transfer (SBT) cycles under an early follicular phase prolonged regimen on the day of trigger. We recruited patients in fresh SBT cycles ( = 771) undergoing early follicular phase prolonged protocols with β-hCG values above 10 IU/L between June 2016 and December 2018. Patients who met the inclusion and exclusion criteria were divided into four groups according to their serum E level percentages