Skip to main content
SpringerLink
Log in

Association of serum estradiol levels on the day of hCG administration with pregnancy rates and embryo scores in fresh ICSI/ET cycles down regulated with either GnRH agonists or GnRH antagonists

  • Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To investigate the interrelation between serum E2 level on hCG day, score of transferred embryos and pregnancy achievement.

Methods

Records of 350 women aged 18–40 years who underwent ovarian hyperstimulation in fresh cycles down regulated either with GnRH agonist (n = 70) or GnRH antagonist (n = 280) followed by oocyte pick-up, ICSI and embryo transfer are retrospectively analyzed.

Results

Median E2 levels on hCG day of cycles ending with and without pregnancy were similar (p = 0.308). ROC curve for AUC of E2 on hCG day with dependent variable pregnancy rate also demonstrated that the E2 level on hCG day cannot be used to predict pregnancy in IVF/ICSI cycles (AUC 0.532, 95 % confidence interval: 0.471–0.593). Grouping cycles according to their E2 levels on hCG day also did not demonstrate any detrimental effect of either low or high E2 levels on hCG day both in agonist and antagonist cycles. Pregnancy rates are strongly correlated with mean and total score of transferred embryos. Interrelation of E2 on hCG day and pregnancy rate is independent from score of transferred embryos.

Conclusions

E2 on hCG day is not correlated with pregnancy rates and cannot be used to predict pregnancy in neither agonist nor antagonist cycles, no matter its level or percentile is used.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Marchini M, Fedele L, Bianchi S, Losa GA, Ghisletta M, Candiani GB (1991) Secretory changes in preovulatory endometrium during controlled ovarian hyperstimulation with buserelin acetate and human gonadotropins. Fertil Steril 55:717–721

    CAS  PubMed  Google Scholar 

  2. Ubaldi F, Bourgain C, Tournaye H, Smitz J, Van Steirteghem A, Devroey P (1997) Endometrial evaluation by aspiration biopsy on the day of oocyte retrieval in the embryo transfer cycles in patients with serum progesterone rise during the follicular phase. Fertil Steril 67:521–526

    Article  CAS  PubMed  Google Scholar 

  3. Van Vaerenbergh I, Van Lommel L, Ghislain V, In’t Veld P, Schuit F, Fatemi HM, Devroey P, Bourgain C (2009) In GnRH antagonist/rec-FSH stimulated cycles, advanced endometrial maturation on the day of oocyte retrieval correlates with altered gene expression. Hum Reprod 24:1085–1091

    Article  PubMed  Google Scholar 

  4. Valbuena D, Martin J, de Pablo JL, Remohi J, Pellicer A, Simon C (2001) Increasing levels of estradiol are deleterious to embryonic implantation because they directly affect the embryo. Fertil Steril 76:962–968

    Article  CAS  PubMed  Google Scholar 

  5. Joo BS, Park SH, An BM, Kim KS, Moon SE, Moon HS (2010) Serum estradiol levels during controlled ovarian hyperstimulation influence the pregnancy outcome of in vitro fertilization in a concentration-dependent manner. Fertil Steril 9:442–446

    Article  Google Scholar 

  6. Van Landuyt L, De Vos A, Joris H, Verheyen G, Devroey P, Van Steirteghem A (2005) Blastocyst formation in in vitro fertilization versus intracytoplasmic sperm injection cycles: influence of the fertilization procedure. Fertil Steril 83:1397–1403

    Article  PubMed  Google Scholar 

  7. Kosmas IP, Kolibianakis EM, Devroey P (2004) Association of estradiol levels on the day of hCG administration and pregnancy achievement in IVF:a systematic review. Hum Reprod 19:2446–2453

    Article  CAS  PubMed  Google Scholar 

  8. Chenette PE, Sauer MV, Paulson RJ (1990) Very high serum E2 levels are not detrimental to clinical outcome of in vitro fertilization. Fertil Steril 54:858–863

    CAS  PubMed  Google Scholar 

  9. Gelety TJ, Buyalos RP (1995) The influence of supraphysiologic E2 levels on human nidation. J Assist Reprod Genet 12:406–412

    Article  CAS  PubMed  Google Scholar 

  10. Simon C, Cano F, Valbuena D, Remohi J, Pellicer A (1995) Clinical evidence for a detrimental effect on uterine receptivity of high serum E2 concentrations in high and normal responder patients. Hum Reprod 10:2432–2437

    Article  CAS  PubMed  Google Scholar 

  11. Yu Ng EH, Yeung WS, Yee Lan Lau E, So WW, Ho PC (2000) High serum E2 concentrations in fresh IVF cycles do not impair implantation and pregnancy rates in subsequent frozen-thawed embryo transfer cycles. Hum Reprod 15:250–255

    Article  CAS  PubMed  Google Scholar 

  12. Dor J, Seidman DS, Ben-Shlomo I, Levran D, Karasik A, Mashiach S (1992) The prognostic importance of the number of oocytes retrieved and E2 levels in poor and normal responders in in vitro fertilization (IVF) treatment. J Assist Reprod Genet 9:228–232

    Article  CAS  PubMed  Google Scholar 

  13. Sharara FI, McClamrock HD (1999) High E2 levels and high oocyte yield are not detrimental to in vitro fertilization outcome. Fertil Steril 72:401–405

    Article  CAS  PubMed  Google Scholar 

  14. Papageorgiou T, Guibert J, Goffinet F, Patrat C, Fulla Y, Janssens Y, Zorn JR (2002) Percentile curves of serum E2 levels during controlled ovarian stimulation in 905 cycles stimulated with recombinant FSH show that high E2 is not detrimental to IVF outcome. Hum Reprod 17:2846–2850

    Article  CAS  PubMed  Google Scholar 

  15. Chen CH, Zhang X, Barnes R, Confino E, Milad M, Puscheck E, Kazer RR (2003) Relationship between peak serum E2 levels and treatment outcome in in vitro fertilization cycles after embryo transfer on day 3 or day 5. Fertil Steril 80:75–79

    Article  PubMed  Google Scholar 

  16. Mettler L, Tavmergen EN (1989) Significance of E2 values in IVF–ET under a combined GnRH analogue–desensitization and simultaneous gonadotropin stimulation for the outcome of pregnancies. Hum Reprod 4(Suppl 8):59–64

    Article  CAS  PubMed  Google Scholar 

  17. Detti L, Yelian FD, Kruger ML, Diamond MP, Rode A, Mitwally MF, Puscheck EE (2008) Endometrial thickness is related to miscarriage rate, but not to the estradiol concentration, in cycles down-regulated with gonadotropin-releasing hormone antagonist. Fertil Steril 89:998–1001

    Article  CAS  PubMed  Google Scholar 

  18. Bahçeci M, Ulug U, Erden HF, Mesut A, Jozwiak EA (2006) Elevated oestradiol concentrations are not associated with increased first trimester miscarriage rates of singleton gestations conceived by assisted conception treatment. Reprod Biomed Online 12:33–38

    Article  PubMed  Google Scholar 

  19. Ulug U, Tosun S, Jozwiak EA, Mesut A, Sismanoglu A, Bahceci M (2006) Subclinical pregnancy losses among women undergoing in vitro fertilization with ICSI. J Assist Reprod Genet 23:261–267

    Article  PubMed  Google Scholar 

  20. Blazar AS, Hogan JW, Frankfurter D, Hackett R, Keefe DL (2004) Serum estradiol positively predicts outcomes in patients undergoing in vitro fertilization. Fertil Steril 81:1707–1709

    Article  PubMed  Google Scholar 

  21. Mitwally MF, Bhakoo HS, Crickard K, Batt RE, Sullivan MW, Yeh J (2006) Estradiol production during controlled ovarian hyperstimulation correlates with treatment outcome in women undergoing in vitro fertilizationembryo transfer. Fertil Steril 86:588–596

    Article  CAS  PubMed  Google Scholar 

  22. Kyrou D, Popovic-Todorovic B, Fatemi HM, Bourgain C, Haentjens P, Van Landuyt L, Devroey P (2009) Does the estradiol level on the day of human chorionic gonadotrophin administration have an impact on pregnancy rates in patients treated with rec-FSH/GnRH antagonist? Hum Reprod 24:2902–2909

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

Authors have no conflict of interest/funding to declare. All authors state that they do not have a financial relationship which can be related to this research. This research is not sponsored by any organization. Authors have had full control of all primary data and agree to allow the Journal to review their data if requested.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Ankara Education and Research Hospital, 329. Cad. No:25/14 Kırkkonaklar, Ankara, Turkey

    Elif Aylin Taşkın

  2. Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey

    Cem Somer Atabekoğlu, Natı Musalı & Murat Sönmezer

  3. Department of Statistics, Ankara University Faculty of Medicine, Ankara, Turkey

    Derya Öztuna

Authors
  1. Elif Aylin Taşkın
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cem Somer Atabekoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Natı Musalı
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Derya Öztuna
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Murat Sönmezer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elif Aylin Taşkın.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Taşkın, E.A., Atabekoğlu, C.S., Musalı, N. et al. Association of serum estradiol levels on the day of hCG administration with pregnancy rates and embryo scores in fresh ICSI/ET cycles down regulated with either GnRH agonists or GnRH antagonists. Arch Gynecol Obstet 289, 399–405 (2014). https://doi.org/10.1007/s00404-013-2984-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-013-2984-8

Keywords

Search

Navigation