title: The degree of serum estradiol decline in early and midluteal phase had no adverse effect on IVF/ICSI outcome.
abstract: BACKGROUND
  Estradiol levels fall rapidly in the luteal phase of ART cycles. So far, the effect of this estradiol decline on pregnancy outcome has remained controversial.
  
  
  OBJECTIVE
  To study the effect of early and midluteal estradiol decline on pregnancy and miscarriage rate. We also sought to determine whether estradiol fall was related to increased risk of bleeding per vagina in the first trimester among pregnancies which crossed 12 weeks.
  
  
  METHODS
  Tertiary Assisted conception center.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  We analyzed data of 360 consecutive patients who underwent IVF-ET/ICSI cycles using one of the three protocols: Midluteal downregulation, short flare, and antagonist protocol.
  
  
  METHODS
  Statistical evaluation was performed with the Student's t test, Chi square, Fischer's exact test, analysis of variance, and Mann-Whitney tests were appropriate using SPSS for Windows, Standard version 11.0.
  
  
  RESULTS
  The mean % EL-E2 and % ML-E2 declines were not significantly different in the pregnant and nonpregnant groups when analyzed separately in the three protocols. Also, the degree of midluteal estradiol decline did not correlate with pregnancy outcome. Moreover, the mean % early and midluteal estradiol decline did not differ significantly in patients with preclinical, clinical abortions, and ongoing pregnancy. The estradiol decline was not found to influence the risk of bleeding in the first trimester.
  
  
  CONCLUSIONS
  Our results show that the degree of estradiol fall in the luteal phase of ART cycles does not influence pregnancy and first trimester miscarriage rate.
authors.affiliation: Department of Reproductive Medicine, Bangalore Assisted Conception Center, #6/7 Kumara Krupa, High Grounds, Bangalore - 560 001, India.
authors.forename: Sachin A
authors.initials: SA
authors.lastname: Narvekar
authors.forename: Neelima
authors.initials: N
authors.lastname: Gupta
authors.forename: Nivedita
authors.initials: N
authors.lastname: Shetty
authors.forename: Anu
authors.initials: A
authors.lastname: Kottur
authors.forename: Ms
authors.initials: M
authors.lastname: Srinivas
authors.forename: Kamini A
authors.initials: KA
authors.lastname: Rao