High estradiol levels and high oocyte yield are not detrimental to in vitro fertilization outcome

Sharara, Fady I.; McClamrock, Howard D.

doi:10.1016/s0015-0282(99)00293-9

Cited by 83 publications

(50 citation statements)

References 18 publications

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“…Low peak estradiol concentration may be in favor of embryos implantation. Although high responders had more retrieved oocytes and goodquality embryos, their pregnancy rates were similar to low and normal responders' (Simon et al, 1998;Sharara and McClamrock, 1999). High estradiol concentration and altered estradiol/progesterone ratios, which also are associated with the impairment of endometrial receptivity, may be the main factors affecting endometrial receptivity in high responders (Simon et al, 1995;Pellicer et al, 1996).…”

Section: Correlation Between Ovarian Response and Pregnancy Outcomementioning

confidence: 85%

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Dynamic measurements of serum inhibin B and estradiol: apredictive evaluation of ovarian response to gonadotrophin stimulation in the early stage of IVF treatment

Miao

Huang

2009

J. Zhejiang Univ. Sci. B

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Abstract:Objective: We dynamically measured serum inhibin B and estradiol in the early stage of hormonal stimulation to predict the ovarian response in in vitro fertilization (IVF) treatment. Methods: A total of 57 patients (<40 years of age) who underwent the first cycle of long protocol IVF or introcytoplasmic sperm injection (ICSI) treatment were included. Serum inhibin B, estradiol, follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were measured four times: (1) on Day 3 of the menstrual cycle (basal); (2) on the day before the first administration of gonadotrophin (Gn) (Day 0); (3) on Day 1 of Gn therapy; and (4) on Day 5 of Gn therapy. Comparisons of these measurements with ovarian responses and pregnancy outcomes were made and analyzed statistically. Results: (1) On Day 1 and Day 5 of recombinant FSH (rFSH) stimulation, ovarian response, i.e., numbers of follicles, oocytes, fertilized oocytes, and embryos, had a positive correlation (r s =0.46~0.61, P=0.000) with raised inhibin B and estradiol concentrations, but a negative correlation (r s =−0.67~−0.38, P=0.000 or P<0.01) with total rFSH dose and total days of rFSH stimulation. (2) No significant variation (P>0.05) between the pregnant and non-pregnant groups on the basis of mean age or on all hormone concentrations at four times of the IVF cycle was observed. However, all the seven patients aged >35 years did not reach pregnancy. Conclusions: (1) Serum inhibin B and estradiol concentrations obtained shortly after Gn therapy may offer an accurate and early prediction of ovarian response; (2) Low levels of serum inhibin B and estradiol obtained shortly after Gn stimulation indicate the need for a longer period of Gn treatment and a higher daily dosage; (3) No obvious pregnancy difference among patients of age <35 years was found; however, IVF pregnancy outcome is significantly lower in women of age >35 years.

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Section: Correlation Between Ovarian Response and Pregnancy Outcomementioning

confidence: 85%

“…However, the correlation between ovarian response and IVF pregnancy outcome remains controversial (Toner et al, 1991a;Simon et al, 1995;1998;Pellicer et al, 1996;Sharara and McClamrock, 1999;Kably et al, 2000;Bancsi et al, 2002).…”

Section: Correlation Between Ovarian Response and Pregnancy Outcomementioning

confidence: 99%

Dynamic measurements of serum inhibin B and estradiol: apredictive evaluation of ovarian response to gonadotrophin stimulation in the early stage of IVF treatment

Miao

Huang

2009

J. Zhejiang Univ. Sci. B

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“…The variability in several of these prior studies may be due to varying estradiol thresholds at which clinically significant differences in implantation and overall pregnancy outcomes were defined. The inconsistent estradiol threshold, in addition to small sample sizes and differences in the study populations, has proved challenging in making adequate comparisons of outcomes and maintaining external validity [16,24,25].…”

Section: Introductionmentioning

confidence: 99%

The impact of supraphysiologic serum estradiol levels on peri-implantation embryo development and early pregnancy outcome following in vitro fertilization cycles

Imudia

Goldman

Awonuga

et al. 2013

J Assist Reprod Genet

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Purpose To determine the impact of elevated serum estradiol levels (EE 2 -defined as levels>90th percentile) on the day of hCG administration during IVF on oocyte fertilization, embryo development, implantation, clinical pregnancy and miscarriage rates. Methods A total of 2,995 consecutive IVF cycles in 1,889 patients with non-donor oocyte retrieval resulting in fresh embryo transfer between 1/1/2005 and 12/31/2011 were analyzed. Cycles were stratified by serum E 2 level on the day of hCG administration into those with levels >90th percentile and≤90th percentile. Rates of normal fertilization, embryo development, positive pregnancy test, implantation, clinical pregnancy and spontaneous miscarriage were compared. Results Serum estradiol above the 90th percentile on the day of hCG administration was associated with a significantly lower rate of normal fertilization (68.6±20 vs. 71.6±21, p = 0.02) when compared with patients with a lower serum estradiol threshold. The proportion of embryos that progressed from 2PN to 6-8 cell on day 3 was not different between the two groups. Although rates of positive pregnancy test (55.2 % vs. 57 %), implantation (26.4 % vs. 28.5 %) and clinical pregnancy (45.5 % vs. 49.4 %) were lower in patients with a higher estradiol threshold, these differences were not statistically significant. Similarly, there was no difference in the spontaneous miscarriage rates between the two groups (8.4 % vs. 7.1 %). Conclusions Serum estradiol levels above the 90th percentile on the day of hCG administration is associated with lower oocyte fertilization rate; however, such levels do not impact embryo development, implantation, clinical pregnancy or spontaneous miscarriage rates.

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“…This has been associated with normal oocytes and embryo quality as similar pregnancy rates were seen in normal and high responders in donor oocytes cycle. In other studies by Sharara et al [4,7] and Papageorgiou et al [14] in which 106 and 905 IVF cycles were studied, respectively, no detrimental effect of high estradiol was seen on oocytes/ embryo quality or pregnancy rate. On the other hand, in the studies by Loutradis et al [13] and Pena et al [9,17], higher serum estradiol on the day of HCG was associated with a larger number of oocytes and embryos and highgrade embryos for transfer/cryopreservation.…”

Section: Discussionmentioning

confidence: 87%

Serum Estradiol as a Predictor of Success of In Vitro Fertilization

Mittal

Gupta

Malhotra

et al. 2013

J Obstet Gynecol India

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Aim The aim of this study was to assess the role of total serum estradiol on the day of injection HCG, estradiol per mature follicle, and estradiol per oocytes retrieved (OR) on clinical pregnancy rate (CPR) and oocyte/embryo quality in assisted reproduction. Materials and Methods A retrospective review of 342 in vitro fertilization cycles with normal ovarian reserve in women who underwent long GnRH agonist protocol was included. The outcomes assessed are number of OR, number of mature oocytes (MO), number of oocytes fertilized (FO), fertilization rate, number of embryos cleaved (EC), cleavage rate (CR), number of Grade I embryos (E), number of cryopreserved embryos (CPE), and CPR. The Estradiol/follicle ratio (E2/fol) was defined as estradiol level per mature follicle [14 mm in diameter. Estradiol/ oocyte (E2/O) ratio was defined as estradiol level per OR. These two ratios were categorized by the 25th percentile into four groups. Results A positive correlation was seen between E2/fol and OR (r = .334, p value = .0001), MO (r = .335, p value = .0001), FO (r = .222, p value = .002), and CPE (r = .289, p value = .0001). Increased CPR was seen in Group C (E2/ fol = 200-299.99) compared to Group A, B, and D (p value = .033). With E2/O ratio, negative correlation was seen between E2/O and OR (r = -.281, p value = .002), MO (r = -.296, p value = .008), FO (r = -.220, p value = .003), EC (r = -.211, p value = .004), Grade 1 embryo (r = -.216, p value = .001), and CPE (r = -.206, p value = .005). No difference in FR, CR, or CPR was seen. No difference was seen in CPR with total serum estradiol. Conclusions In conclusion, serum estradiol is an important determinant of IVF success. While total serum estradiol does not exert any positive or negative influence on IVF outcome, estradiol per mature follicle and retrieved oocytes do have an impact. Pregnancy rate is better when E2/fol is between 200 and 299.99 pg/ml. Also, increasing serum E2/fol positively correlates with better oocytes and embryo quality. In contrast, E2/O negatively correlates with oocytes and embryo quality parameters.

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High estradiol levels and high oocyte yield are not detrimental to in vitro fertilization outcome

Cited by 83 publications

References 18 publications

Dynamic measurements of serum inhibin B and estradiol: apredictive evaluation of ovarian response to gonadotrophin stimulation in the early stage of IVF treatment

Dynamic measurements of serum inhibin B and estradiol: apredictive evaluation of ovarian response to gonadotrophin stimulation in the early stage of IVF treatment

The impact of supraphysiologic serum estradiol levels on peri-implantation embryo development and early pregnancy outcome following in vitro fertilization cycles

Serum Estradiol as a Predictor of Success of In Vitro Fertilization

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