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Is the probability of pregnancy after ovarian stimulation for IVF associated with serum estradiol levels on the day of triggering final oocyte maturation with hCG? A systematic review and meta-analysis

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Abstract

Purpose

The objective of this systematic review and metaanalysis was to examine if the probability of pregnancy after ovarian stimulation for in vitro fertilization (IVF), using GnRH analogues and gonadotrophins is associated with serum estradiol level (Ε2) on the day of triggering final oocyte maturation with human chorionic gonadotrophin (hCG).

Methods

Twenty-one studies were eligible for this systematic review, including 19,598 IVF cycles, whereas three studies were eligible for metaanalysis, including 641 IVF cycles. The main outcome measure was achievement of ongoing pregnancy/live birth and, if not available, clinical pregnancy or biochemical pregnancy.

Results

Pooling of data showed no differences in the probability of clinical pregnancy between patients with high and low Ε2 levels on the day of triggering final oocyte maturation. The pooled effect sizes for the Ε2 thresholds groups constructed, regarding clinical pregnancy were 2000–3000 pg/mL—OR 0.91, 95% CI 0.55 to 1.50, (fair quality/moderate risk of bias, n = 1 study), 3000–4000 pg/mL—OR 0.89, 95% CI 0.46 to 1.70, (fair quality/moderate risk of bias, n = 1 study, good quality/no information on which to base a judgement about risk of bias n = 2 studies), 4000–5000 pg/mL—OR 0.74, 95% CI 0.37 to 1.49 fair quality/moderate risk of bias, n = 1 study), 5000–6000 pg/mL—OR 0.62, 95% CI 0.19 to 1.98, (fair quality/moderate risk of bias, n = 1 study). In addition, no difference was observed in the probability of ongoing pregnancy for the Ε2 threshold group of 3000–4000 pg/mL OR 0.85, 95% CI 0.40 to 1.81(good quality/no information on which to base a judgement about risk of bias, n = 1 study).

Conclusion

Currently, there is insufficient evidence to support or deny the presence of an association between the probability of pregnancy and serum Ε2 levels on the day of triggering final oocyte maturation with hCG in women undergoing ovarian stimulation for IVF.

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Authors and Affiliations

  1. 1st Department of Obstetrics and Gynecology, Unit for Human Reproduction, Papageorgiou General Hospital, Medical School, Aristotle University of Thessaloniki, Efkarpia, 56403, Thessaloniki, Greece

    Glykeria I. Karatasiou, J. K. Bosdou, L. Zepiridis, K. Chatzimeletiou, T. B. Tarlatzi, B. C. Tarlatzis, G. Grimbizis & E. M. Kolibianakis

  2. Centre for Big Data Research in Health & School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia

    C. A. Venetis

  3. FIVI Fertility &IVF Center, Interbalkan Medical Center, Thessaloniki, Greece

    T. B. Tarlatzi

  4. Eugonia Assisted Reproduction Unit, Athens, Greece

    G. Lainas

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  1. Glykeria I. Karatasiou
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Contributions

Karatasiou G. performed the literature search and data analysis, manuscript writing and editing. Bosdou J., Venetis C. Zepiridis L., Chatzimeletiou K., Tarlatzi T., Lainas G., Tarlatzis B. and Grimbizis G. critically revised the work, and Kolibianakis E. had the idea for the article, performed data analysis and manuscript editing.

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Correspondence to Glykeria I. Karatasiou.

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Karatasiou, G.I., Bosdou, J.K., Venetis, C.A. et al. Is the probability of pregnancy after ovarian stimulation for IVF associated with serum estradiol levels on the day of triggering final oocyte maturation with hCG? A systematic review and meta-analysis. J Assist Reprod Genet 37, 1531–1541 (2020). https://doi.org/10.1007/s10815-020-01829-z

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