Estradiol production during controlled ovarian hyperstimulation correlates with treatment outcome in women undergoing in vitro fertilization-embryo transfer.
OBJECTIVE
To study the value of E(2) production during controlled ovarian hyperstimulation (COH) in predicting IVF-ET outcome.


METHODS
Historical cohort.


METHODS
Academic infertility center.


METHODS
A cohort of 270 patients who completed 324 consecutive IVF-ET treatment cycles.


METHODS
None.


METHODS
Area under the curve for E(2) levels (AUC-E(2)) from the first day of COH until the day of hCG administration was calculated and cycles grouped into low, average, and high AUC-E(2) groups. Clinical pregnancy rates per cycle were compared among the three groups, and correlations with AUC-E(2) values were calculated for all patients and after sub-grouping according to age, COH protocol and infertility diagnosis.


RESULTS
Cycles with low and high AUC-E(2) values had significantly lower pregnancy rates particularly in patients 35 years or older. There was a positive correlation between AUC-E(2) and pregnancy rates up to a certain AUC-E(2) level above which a negative correlation was found. The turning point between positive and negative correlations occurred at a significantly lower AUC-E(2) level in patients 35 years or older.


CONCLUSIONS
Estradiol production during COH correlates with IVF-ET outcome. Women >35 years of age seem more vulnerable to high E(2) levels.
Mitwally
Mohamed F M
MF
Department of Gynecology-Obstetrics, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York 14222, USA.
Bhakoo
Helmata S
HS
Crickard
Kent
K
Sullivan
Michael W
MW
Batt
Ronald E
RE
Yeh
John
J
D000328:Adult; D017677:Age Distribution; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004624:Embryo Transfer / Q000706:statistics & numerical data*; D004958:Estradiol / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D006801:Humans; D007247:Infertility, Female / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D009518:New York / Q000453:epidemiology; D010062:Ovulation Induction / Q000706:statistics & numerical data*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D013223:Statistics as Topic; D016896:Treatment Outcome
D015415:Biomarkers; D004958:Estradiol