Low serum estradiol concentrations after five days of controlled ovarian hyperstimulation for in vitro fertilization are associated with poor outcome.
OBJECTIVE
To evaluate the prognostic significance of low serum E2 concentrations in controlled ovarian hyperstimulation (COH) cycles for IVF.


METHODS
Retrospective study.


METHODS
Assisted conception unit of a university hospital.


METHODS
One thousand four hundred and forty patients undergoing COH for IVF.


METHODS
COH, serum E2 measurement, ultrasonographic scanning of ovarian follicles, oocyte retrieval, and ET.


METHODS
Cancellation and pregnancy rates.


RESULTS
Patients were classified into four groups according to serum E2 levels on the sixth day of COH: group A (E2 level < 50 pg/mL [114 cycles]), group B (E2 level 51-100 pg/mL [189 cycles]), group C (E2 level 101-200 pg/mL [320 cycles]), and group D (E2 level >200 pg/mL [817 cycles]). Group A experienced the highest cancellation rates (65.1%) and lowest pregnancy rates (7.8%) despite requiring significantly more hMG ampules (47.8+/-1.7). The cancellation rate was higher (75.1%) and no pregnancy occurred in a subset of group A in whom COH was initiated with > or =3 ampules (225 IU) of gonadotropins.


CONCLUSIONS
In COH cycles using luteal phase buserelin, low initial serum E2 concentrations are associated with poor outcome.
Khalaf
Y
Y
Guy's and St. Thomas' Assisted Conception Unit, St. Thomas' Hospital, London, United Kingdom. y.khalaf@umds.ac.uk
Taylor
A
A
Braude
P
P
D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D004958:Estradiol / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005498:Follicular Phase; D006801:Humans; D008596:Menotropins / Q000627:therapeutic use; D017063:Outcome Assessment, Health Care; D010062:Ovulation Induction / Q000009:adverse effects*; D011247:Pregnancy; D011379:Prognosis
D006063:Chorionic Gonadotropin; D004958:Estradiol; D008596:Menotropins