title: A rapid decline in serum oestradiol concentrations around the mid-luteal phase had no adverse effect on outcome in 763 assisted reproduction cycles.
abstract: Progesterone is essential in the luteal phase whereas luteal oestradiol may play only a permissive role on the endometrium. However, a rapid decline in oestradiol concentrations around the mid-luteal period may compromise the endometrial integrity leading to poor IVF outcomes. A retrospective analysis of 763 women aged <40 years undergoing their first IVF cycle and having < or =3 embryos replaced was undertaken. In cycles receiving human chorionic gonadotrophin (HCG) for luteal support, 25th, 50th and 75th centiles of the ratio of day-of-HCG oestradiol to mid-luteal oestradiol (oestradiol ratio) were 1.8, 2.8 and 5.0 respectively. Hormonal parameters were not different between pregnant and non-pregnant cycles. The outcomes were similar irrespective of the oestradiol ratio. Progesterone supplementation was used instead when the HCG oestradiol was >18 000 pmol/l or there were features of ovarian hyperstimulation syndrome. Pregnancy rates of these hyperstimulated cycles were 16.7 and 11.4% per cycle respectively when oestradiol ratio was < or =5.0 and >5.0. This difference did not reach statistical significance. Our results could not find an adverse outcome in cycles showing a rapid decline in oestradiol during the mid-luteal phase.
authors.affiliation: Department of Obstetrics & Gynaecology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China. nghye@hkucc.hku.hk
authors.forename: E
authors.initials: E
authors.lastname: Hung Yu Ng
authors.forename: W
authors.initials: W
authors.lastname: Shu Biu Yeung
authors.forename: E
authors.initials: E
authors.lastname: Yee Lan Lau
authors.forename: W
authors.initials: W
authors.lastname: Wai Ki So
authors.forename: P
authors.initials: P
authors.lastname: Chung Ho
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D010064:Embryo Implantation; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008183:Luteal Phase; D011247:Pregnancy; D011374:Progesterone / Q000008:administration & dosage; D012099:Reproductive Techniques; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D006063:Chorionic Gonadotropin; D011374:Progesterone; D004958:Estradiol