Serum estradiol/progesterone ratio on day of embryo transfer may predict reproductive outcome following controlled ovarian hyperstimulation and in vitro fertilization

Abstract

Background: To determine whether estradiol-to-progesterone (E 2 /P) ratios at the time of embryo transfer (ET) have an effect on implantation and pregnancy in IVF cycles.

The use of estradiol for luteal phase support in in vitro fertilization/intracytoplasmic sperm injection cycles: a systematic review and meta-analysis

“…On the contrary, other investigators have found no correlation between the luteal P4/E 2 ratio and pregnancy in IVF cycles (39). More recently, it has been demonstrated that an elevated luteal P4/E 2 ratio predicted reliably IVF clinical pregnancies (40). Several case reports of successful outcomes when supplemental luteal E 2 was inadvertently omitted in donor oocytes cycles raised doubts about the need for E 2 in the luteal phase (41,42).…”

The effect of luteal phase support protocol on cycle outcome and luteal phase hormone profile in long agonist protocol intracytoplasmic sperm injection cycles: a randomized clinical trial

“…Apparently it is not the absolute value of sex steroids that predict cycle outcome, but rather the E 2 :P 4 ratio at the time of implantation, among other things, is more important. Gruber et al (29) in a retrospective study showed that the E 2 :P 4 ratio at the time of implantation could differentiate between pregnant and nonpregnant cycles. In their study Gruber et al (29) found that the E 2 :P 4 ratio on the day of hCG ovulation triggering þ7 days was 15.4 AE 6.2 in the clinically pregnant cases compared with 6.5 AE 7.6, 5.8 AE 10.7 for preclinical abortions and nonpregnant cases, respectively (P<.001).…”

“…Gruber et al (29) in a retrospective study showed that the E 2 :P 4 ratio at the time of implantation could differentiate between pregnant and nonpregnant cycles. In their study Gruber et al (29) found that the E 2 :P 4 ratio on the day of hCG ovulation triggering þ7 days was 15.4 AE 6.2 in the clinically pregnant cases compared with 6.5 AE 7.6, 5.8 AE 10.7 for preclinical abortions and nonpregnant cases, respectively (P<.001). In support of this, our data showed significantly higher midluteal E 2 :P 4 ratio in the E 2 -supported arm (group II) ( Table 3) compared with the other two study arms (I, II).…”

A comparison of the effects of three different luteal phase support protocols on in vitro fertilization outcomes: a randomized clinical trial

“…Some studies report the E 2 /P rate to have a role in successful pregnancy outcomes in ovulation induction cycles (31,32). In the study of Gruber et al (33) on IVF cycles, with respect to the E 2 /P rate, pregnant patients had higher rates on all 3 days (33). Ghanem et al (9) found that the midluteal E 2 /P ratio was significantly higher in the E 2 þ P group compared with the other two groups.…”