title: The decline in serum estradiol on the second day after oocyte retrieval affects the outcome of IVF/ICSI-ET treatment in high ovarian responders.
abstract: OBJECTIVE
  To investigate the predictive value of the decline in serum estradiol on the second day after oocyte retrieval on the outcomes of in vitro fertilization (IVF) or intra-cytoplasmic sperm injection and embryo transfer (ICSI-ET) among high ovarian responders.
  
  
  METHODS
  Retrospective single-center cohort study.
  
  
  METHODS
  Tertiary-care, university-affiliated teaching hospital. Patients Women aged 20-45 years undergoing assisted reproduction treatment from June 2014 to December 2015.
  
  
  METHODS
  A total of 980 cycles were included; 395 high responders (Group 1) and 256 normal responders (Group 3) underwent embryo transfer (ET) in fresh ET cycles. A total of 329 high ovarian responders who underwent cryopreservation of all embryos (Group 2) were recruited as controls. The cases were divided into the following five subgroups according to the rate of serum estradiol decline on the second day after oocyte retrieval: 50.00-59.99% (Subgroup A), 60.00-69.99% (Subgroup B), 70.00-79.99% (Subgroup C), 80.00-89.99% (Subgroup D) and ≥ 90.00% (Subgroup E). The clinical outcomes were analyzed.
  
  
  METHODS
  Clinical pregnancy rate, implantation rate.
  
  
  RESULTS
  In Group 1, the pregnancy rate decreased from 51.33 to 36.72% and the implantation rate decreased from 30.93 to 21.70% when the level of serum estradiol on the second day after oocyte retrieval decreased by more than 80%, which was a statistically significant decline (p < 0.05). The peak estradiol (E2) value and implantation rate were also significantly different (p < 0.05). In Group 2, the decline of serum E2on the second day after oocyte retrieval had no significant effect on the clinical pregnancy rate or the implantation rate. The trend was similar in Group 3.
  
  
  CONCLUSIONS
  A decline in the E2level of > 80% after oocyte retrieval may play an important role in unsatisfactory IVF/ICSI-ET outcomes among high ovarian responders.
authors.affiliation: a Medical Center for Human Reproduction, Beijing Chaoyang Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Xueyan
authors.initials: X
authors.lastname: Bai
authors.affiliation: a Medical Center for Human Reproduction, Beijing Chaoyang Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: a Medical Center for Human Reproduction, Beijing Chaoyang Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Shan
authors.initials: S
authors.lastname: Liu
authors.affiliation: a Medical Center for Human Reproduction, Beijing Chaoyang Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Danni
authors.initials: D
authors.lastname: Qu
authors.affiliation: a Medical Center for Human Reproduction, Beijing Chaoyang Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Hui
authors.initials: H
authors.lastname: Su
authors.affiliation: a Medical Center for Human Reproduction, Beijing Chaoyang Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Haiying
authors.initials: H
authors.lastname: Ren
authors.affiliation: a Medical Center for Human Reproduction, Beijing Chaoyang Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
mesh_terms: D000328:Adult; D010064:Embryo Implantation; D004624:Embryo Transfer / Q000706:statistics & numerical data*; D004958:Estradiol / Q000097:blood*; D005260:Female; D006801:Humans; D008875:Middle Aged; D054315:Oocyte Retrieval; D010062:Ovulation Induction / Q000009:adverse effects*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D055815:Young Adult
chemical_list: D004958:Estradiol
keywords: Clinical pregnancy rate; early luteal phase; estradiol; high ovarian response; implantation rate; in vitro fertilization