title: Serum estradiol levels after 4 days of ovarian hyperstimulation in oocyte donors are predictive of embryo quality and clinical outcomes.
abstract: OBJECTIVE
  To determine whether estradiol (E(2)) levels after 4 days of ovarian hyperstimulation in leuprolide-downregulated cycles are predictive of embryo quality and pregnancy outcome in oocyte donation.
  
  
  METHODS
  Retrospective analysis of 287 consecutive oocyte donation cycles performed at a university assisted reproduction therapy program between January 1996 and December 2000. Oocyte donors and recipients followed a non-varied standard synchronization regimen. A serum E(2) (day-5 E(2)) was obtained from egg donors the morning after leuprolide acetate downregulation and 4 days after hMG/FSH administration. Day-5 E(2) was categorized into 3 groups: group I <75 pg/ml; group II 75-350 pg/ml, and group III > or =350 pg/ml. All embryo transfers were performed 3 days after oocyte recovery.
  
  
  RESULTS
  Elevated day-5 E(2) levels were directly correlated with higher average embryo scores, greater number of oocytes retrieved, and greater number of embryos available for transfer and cryopreservation. Improved pregnancy outcomes were also noted for group III (day-5 E(2) level >350 pg/ml).
  
  
  CONCLUSIONS
  After 4 days of gonadotropin stimulation, an E(2) level of >350 pg/ml is most predictive of higher embryo grade and pregnancy outcome in oocyte donation.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Peña
authors.forename: Peter L
authors.initials: PL
authors.lastname: Chang
authors.forename: Melvin H
authors.initials: MH
authors.lastname: Thornton
authors.forename: Mark V
authors.initials: MV
authors.lastname: Sauer
mesh_terms: D000328:Adult; D004624:Embryo Transfer; D004622:Embryo, Mammalian / Q000502:physiology*; D004958:Estradiol / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage; D008596:Menotropins / Q000008:administration & dosage; D018587:Oocyte Donation; D010062:Ovulation Induction; D011247:Pregnancy; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome
chemical_list: D004958:Estradiol; D008596:Menotropins; D005640:Follicle Stimulating Hormone; D016729:Leuprolide