The Follicular Phase Stimulated by Human Pituitary Gonadotropin and the Luteal Phase Following in Vitro Fertilization

Abstract

The pattern of follicular and luteal phase levels of serum estradiol-17 beta (E2) and progesterone (P) are compared between 5 conception (group P) and 27 nonconception (group N) cycles of patients undergoing in vitro fertilization and embryo transfer. Follicle growth was induced with human pituitary gonadotropin and controlled by daily ovarian ultrasonography measuring the follicular diameters. Group N has significantly (p less than 0.025) higher E2 levels from day -10 up to d-6 as compared with the group P. The day of laparoscopy is designated day 0. In group N the length of E2 phase with E2 levels, exceeding 1.84 nmol/l (500 pg/ml) serum, is greater (p less than 0.001) than in group P 6.9 and 5.6 days, respectively. It is suggested that modifications occur in the endometrium caused by high E2 levels acting for a long time, which disturb the implantation of transferred embryos. No significant differences exist between group N and P, if the diameters of the largest follicle or the mean diameters of the secondary follicles or the number of follicles with a diameter greater than 14 mm are compared. No significant correlations were found between these variables and the E2 levels. A significant correlation (r = 0.85, 14 patients) exists between the E2 rise and the increase of follicular diameters.