[High concentrations of serum estradiol in assisted reproduction].
OBJECTIVE
To analyze the influence of the levels of estradiol on the day of HCG in the pregnancy rate (PR) of ICSI and oocyte donation.


METHODS
Retrospective, comparative.


METHODS
333 patients underwent ICSI and 66 in oocyte donation were included dividing them according to the level of estradiol: a) < 1,000 pg/mL, b) 1,001-3,000 pg/mL and c) > 3,000 pg/mL. Therapeutic protocol: Down regulation with acetate leuprolide in late luteal phase, COH with FSHr and/or HMG, ultrasonographic monitoring and estradiol blood levels, HCG application with > 3 follicles > 18 mm, oocyte retrieval 34 hours later. We analyzed: PR, age (including receptors), FSH and LH. Number, mature grade and fertilized oocytes; luteal support, transfer quality and type of catheter. Statistical analysis (SPSS 11) with chi square, ANOVA and Kruskall-Wallis.


RESULTS
ICSI: Older patients in group A (p < 0.001), but without difference between B and C groups (p = 0.08). Statistical difference in number of follicles, number of oocytes, fertilized oocytes and transferred embryos being less in the A group (p < 0.001). Statistical difference in PR 21.7, 35.6 and 25.7% in A, B and C groups respectively (p = 0.032). Oocyte donation: Group A has younger patients (p = 0.005), FSH and LH were similiar among groups. Major number of follicles were observed to increase estradiol levels, but major quantity of metaphase II and fertilized oocytes were observed in group B (p = 0.05). PR without significant differences: 50, 51.5 and 52.3% in groups A, B and C (p = 0.977). Without statistical difference in the age of receptors; transferred embryos, type of catheter and quality on ICSI and oocyte donation groups.


CONCLUSIONS
High estradiol levels at the day of HCG application affect the PR in patients submitted to ICSI. The best results were obtained with estradiol levels between 1,000 and 3,000 pg/mL. In oocyte donation the high concentrations of estradiol do not affect the PR of the receptors.
Saucedo de la Llata
Eric
E
Instituto para el Estudio de la Concepción Humana, Monterrey, NL.
Moraga Sánchez
María Rosa
MR
Pezino Rodríguez
Jorge
J
Treviño
Armando
A
Leal Almeida
Manuel
M
Sepúlveda
José
J
Arenas Montezco
Lidia
L
García Villafaña
Genaro
G
Batiza Resendiz
Victor Alfonso
VA
Santos Haliscak
Roberto
R
Galache Vega
Pedro
P
Hernández Ayup
Samuel
S
D000328:Adult; D004958:Estradiol / Q000097:blood*; D005260:Female; D006801:Humans; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic
D004958:Estradiol