Correlation of serum estradiol level on the day of ovulation trigger with the reproductive outcome of intracytoplasmic sperm injection.
BACKGROUND
Serum estradiol (E2) levels are measured in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI), to assess the ovarian response and to predict ovarian hyperstimulation syndrome. The impact of peak E2 levels on IVF-ICSI outcome was found to be inconsistent in the previous studies.


OBJECTIVE
To evaluate the impact of the serum E2 levels on the day of ovulation trigger with the reproductive outcome of ICSI.


METHODS
Retrospective observational study. ART Center, at a Tertiary Care University Teaching Hospital.


METHODS
Eighty-nine infertile women, who underwent ICSI with fresh embryo transfer over a period of 3 years, were included in the study. The study subjects were grouped based on the serum E2 level on the day of ovulation trigger:- Group I - <1000 pg/ml, Group II - 1000-2000 pg/ml, Group III - 2000.1-3000 pg/ml, Group IV - 3000.1-4000 pg/ml, and Group V >4000 pg/ml. The baseline characteristics and controlled ovarian hyperstimulation (COH) outcome were compared among the study groups.


METHODS
Chi-square test, Student's t-test, ANOVA, and logistic regression analysis.


RESULTS
The study groups were comparable with regard to age, body mass index, ovarian reserve. Group V had significantly higher number of oocytes retrieved than I and II (18.90 vs. 11.36 and 11.33; P = 0.009). Group IV showed significantly higher fertilization rate than I, III, and V; (92.23 vs. 77.43, 75.52, 75.73; P = 0.028). There were no significant differences in the implantation rates (P = 0.368) and pregnancy rates (P = 0.368).


CONCLUSIONS
Higher E2 levels on the day of ovulation trigger would predict increased oocyte yield after COH. E2 levels in the range of 3000-4000 pg/ml would probably predict increased fertilization and pregnancies in ICSI cycles.
Department of Reproductive Medicine, Sri Ramachandra University, Chennai, Tamil Nadu, India.
N
N
Siddhartha
Department of Reproductive Medicine, Sri Ramachandra University, Chennai, Tamil Nadu, India.
N Sanjeeva
NS
Reddy
Department of Reproductive Medicine, Sri Ramachandra University, Chennai, Tamil Nadu, India.
Monna
M
Pandurangi
Department of Reproductive Medicine, Sri Ramachandra University, Chennai, Tamil Nadu, India.
M
M
Tamizharasi
Department of Reproductive Medicine, Sri Ramachandra University, Chennai, Tamil Nadu, India.
V
V
Radha
Department of Reproductive Medicine, Sri Ramachandra University, Chennai, Tamil Nadu, India.
K
K
Kanimozhi
Embryo quality; estradiol; fertilization; hCG; implantation; intracytoplasmic sperm injection; oocyte; ovulation trigger; pregnancy