Value of estradiol response after human chorionic gonadotropin administration in predicting in vitro fertilization success.
OBJECTIVE
To determine whether the serum E2 response after the administration of exogenous hCG is predictive of outcome during IVF.


METHODS
Prospective, noncomparative cohort.


METHODS
Two academic centers and one private-practice IVF program.


METHODS
Two hundred twenty-two couples undergoing IVF for infertility arising from ovarian dysfunction, asthenoteratospermia, endometriosis, tubal disease, or unexplained infertility.


METHODS
Implantation, pregnancy, and miscarriage rates were compared in cycles that demonstrated an increase, decrease, or plateau in the serum E2 level on the day after hCG administration. The effects of age, cause of infertility, and maximum E2 value on outcome were evaluated.


RESULTS
Ninety-two cycles resulted in a clinical pregnancy and 130 cycles failed. Of 115 cycles in which the E2 level rose, 42 (37%) resulted in an ongoing pregnancy; among cycles with plateauing E2 responses, 20 of 69 (29%) resulted in a pregnancy. Fifteen of 38 (39%) of cycles exhibiting a drop in serum E2 resulted in an ongoing pregnancy. No statistically significant differences in ongoing pregnancy rates were noted in the increasing, plateauing, or decreasing E2 response groups.


CONCLUSIONS
E2 values obtained on the day after hCG administration are not predictive of outcome in women undergoing IVF.
Meyer
W R
WR
Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 27599-7570, USA.
Beyler
S A
SA
Baker
S T
ST
Somkuti
S G
SG
Lowden
D A
DA
Grainger
D A
DA
D000328:Adult; D000367:Age Factors; D006063:Chorionic Gonadotropin / Q000008:administration & dosage*; D015331:Cohort Studies; D010064:Embryo Implantation; D004958:Estradiol / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000209:etiology / Q000628:therapy; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome
D006063:Chorionic Gonadotropin; D004958:Estradiol