title: Falling estradiol levels on day after human chorionic gonadotropin administration in assisted reproductive technology cycles are not predictive of decreasing oocyte maturity or pregnancy rates.
abstract: OBJECTIVE
  To determine whether a fall in serum estradiol levels the day after human chorionic gonadotropin (hCG) administration correlated with the incidence of a positive serum hCG in fresh, nondonor assisted reproductive technology (ART) cycles.
  
  
  METHODS
  A total of 1,969 women undergoing fresh, nondonor ART cycles at a tertiary referral fertility clinic between January 1, 2003, and January 31, 2010, were included and retrospectively analyzed. Primary outcome measures were oocyte maturity and positive serum beta-hCG.
  
  
  RESULTS
  A total of 1,969 cycles met inclusion criteria, of which 1,875 had the same or increasing serum estradiol levels and 94 had decreasing estradiol levels on the morning after hCG trigger administration (6-11 hours after hCG injection). There were no statistically significant differences between the groups with respect to age, baseline FSH levels, type of pituitary downregulation, total ampules of gonadotropin administered, days of stimulation, average number of oocytes retrieved, or oocyte maturity. Probability of pregnancy in women with declining E2 levels after hCG trigger administration did not differ from patients with the same or rising estradiol levels (53% vs. 54%, p = 0.89).
  
  
  CONCLUSIONS
  Absolute change in estradiol levels the morning after beta-hCG administration were not predictive of positive hCG.
authors.forename: Gary
authors.initials: G
authors.lastname: Levy
authors.forename: Micah
authors.initials: M
authors.lastname: Hill
authors.forename: Stephanie
authors.initials: S
authors.lastname: Beall
authors.forename: Justin D
authors.initials: JD
authors.lastname: Pilgrim
authors.forename: Mark
authors.initials: M
authors.lastname: Payson
authors.forename: Anthony
authors.initials: A
authors.lastname: Propst
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage* / Q000097:blood; D004958:Estradiol / Q000097:blood*; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage; D009865:Oocytes / Q000502:physiology*; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic
chemical_list: D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D004958:Estradiol; D005640:Follicle Stimulating Hormone; D016729:Leuprolide