Day 3 estradiol serum concentrations as prognosticators of ovarian stimulation response and pregnancy outcome in patients undergoing in vitro fertilization.
OBJECTIVE
To test the hypothesis that elevated E2 levels on day 3 of IVF cycles without GnRH agonist (GnRH-a) are associated with reduced oocyte numbers and pregnancy rates (PRs).


METHODS
Day 3 levels of E2 and FSH were obtained from patients undergoing controlled ovarian hyperstimulation without GnRH analogue for IVF.


METHODS
Five hundred ninety-two consecutive IVF cycles.


RESULTS
Patients were grouped according to their day 3 E2 levels (< 30, 31 to 45, 46 to 60, 61 to 75, and > 75 pg/mL [conversion factor to SI unit, 3.671]). The ongoing PR per retrieval for patients with E2 levels < 30 pg/mL was significantly higher than for patients with E2 levels 31 to 75 pg/mL. There were no pregnancies if the E2 level was > 75 pg/mL. The mean number of oocytes per retrieval was significantly lower in patients from the E2 groups with E2 > 60 pg/mL compared with patients in groups with E2 < 60 pg/mL. Day 3 FSH and E2 levels also were evaluated simultaneously. In patients with the lowest levels of FSH and E2, the PR was the highest. No pregnancies occurred if the FSH level was > 17 mIU/mL (conversion factor to SI unit, 1.00) and the E2 level was > 45 pg/mL on day 3.


CONCLUSIONS
For patients undergoing IVF without GnRH analogue, oocyte numbers and PRs decrease with increasing levels of day 3 E2. Combining day 3 FSH and E2 improved the prognostic ability of either of these hormones used alone.
Licciardi
F L
FL
Department of Obstetrics and Gynecology, New York Hospital-Cornell University Medical College, New York, USA.
Liu
H C
HC
Rosenwaks
Z
Z
D000328:Adult; D004958:Estradiol / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro / Q000592:standards*; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D010060:Ovulation / Q000097:blood / Q000502:physiology*; D010062:Ovulation Induction; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011863:Radioimmunoassay; D013997:Time Factors
D004958:Estradiol; D005640:Follicle Stimulating Hormone