Elevated levels of basal estradiol-17beta predict poor response in patients with normal basal levels of follicle-stimulating hormone undergoing in vitro fertilization.
OBJECTIVE
To evaluate whether the predictive ability of a normal FSH level on cycle day 3 can be enhanced by levels of estradiol-17beta (E2) on cycle day 3.


METHODS
Prospective cohort study.


METHODS
University hospital-based, tertiary care infertility center.


METHODS
Two hundred thirty-one consecutively seen patients who attended the center for their first IVF attempt.


METHODS
Blood samples were collected on day 3 of the cycle preceding IVF; IVF was performed in all patients.


METHODS
Patient's age, number of ampules of hMG, cancellation rate, number of oocytes, fertilization rate, and clinical pregnancy rate.


RESULTS
In patients with elevated FSH levels on cycle day 3, a low oocyte yield was achieved (7 versus 11) and a high number of ampules of hMG was necessary (56 versus 33). Their cancellation rate was high (67% versus 16%). In patients with normal basal FSH levels, high E2 levels predicted a high cancellation rate (56%, versus 13% in patients with low E2 levels) and a low oocyte yield (9, versus 11 in patients with low E2 levels). Patients with both normal FSH levels and low E2 levels on cycle day 3 fared best.


CONCLUSIONS
The basal E2 level on cycle day 3 is a useful prognosticator of response to stimulation in IVF patients with normal basal FSH levels.
Evers
J L
JL
Department of Obstetrics and Gynecology, Academisch Ziekenhuis Maastricht and The University of Maastricht, The Netherlands.
Slaats
P
P
Land
J A
JA
Dumoulin
J C
JC
Dunselman
G A
GA
D000328:Adult; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood*; D005260:Female; D005306:Fertilization / Q000502:physiology; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D016013:Likelihood Functions; D011247:Pregnancy; D018873:Pregnancy Rate; D011379:Prognosis; D011446:Prospective Studies; D012016:Reference Values
D004958:Estradiol; D005640:Follicle Stimulating Hormone