title: Programming in vitro fertilization retrievals during working days after a gonadotropin-releasing hormone antagonist protocol with estrogen pretreatment: does the length of exposure to estradiol impact on controlled ovarian hyperstimulation outcomes?
abstract: OBJECTIVE
  To verify whether a variable number of days beyond the menses of estrogen (E) pretreatment may impact on controlled ovarian hyperstimulation (COH) outcomes and birth rate using a GnRH antagonist protocol.
  
  
  METHODS
  Single center, prospective, nonrandomized study.
  
  
  METHODS
  Nonacademic fertility unit.
  
  
  METHODS
  A total of 1,080 women, aged 25-38 years, consecutively included (1,603 cycles).
  
  
  METHODS
  Given 4 mg/d E(2) valerate, started 3 days before the theoretical date of the next menses up to the first day of stimulation (S1).
  
  
  METHODS
  Hormone serum levels, drug exposure, and main IVF outcomes.
  
  
  RESULTS
  The cancellation rate was similar in the six similarly sized groups according to the number of days with E(2) pretreatment beyond the menses (1-8 days). The mean serum E(2) and LH levels at S1 gradually increased along with E(2) exposure, whereas the mean serum P level decreased. The mean serum E(2) level on the day of hCG administration gradually increased along with E(2) exposure. Serum LH level at S1 correlated significantly and positively to the length of E(2) exposure and to E(2) level on the day of hCG administration. No significant difference was observed for the number of oocytes retrieved and the number of embryos obtained. Women exposed the longest to exogenous E(2) tended to have higher pregnancy rates (PR).
  
  
  CONCLUSIONS
  Extending E(2) pretreatment beyond the menses had no deleterious effect on the main COH outcomes and proved to be slightly beneficial.
authors.affiliation: Clinique Mutualiste La Sagesse, Rennes, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Guivarc'h-Levêque
authors.forename: Lionel
authors.initials: L
authors.lastname: Homer
authors.forename: Philippe
authors.initials: P
authors.lastname: Arvis
authors.forename: Pierre Louis
authors.initials: PL
authors.lastname: Broux
authors.forename: Ludovic
authors.initials: L
authors.lastname: Moy
authors.forename: Gérard
authors.initials: G
authors.lastname: Priou
authors.forename: Jean
authors.initials: J
authors.lastname: Vialard
authors.forename: Daniel
authors.initials: D
authors.lastname: Colleu
authors.forename: Didier
authors.initials: D
authors.lastname: Dewailly
mesh_terms: D000328:Adult; D004958:Estradiol / Q000008:administration & dosage / Q000097:blood; D004967:Estrogens / Q000008:administration & dosage* / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors* / Q000097:blood; D006801:Humans; D054315:Oocyte Retrieval / Q000379:methods*; D016471:Ovarian Hyperstimulation Syndrome / Q000097:blood / Q000209:etiology; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate / Q000639:trends; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D004967:Estrogens; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol