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Different ART outcomes at increasing peak estradiol levels with long and antagonist protocols: retrospective insights from ten years experience

  • Assisted Reproduction Technologies
  • Published:
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Abstract

Purpose

To evaluate the impact of high estradiol (E2) levels on assisted reproductive technologies outcomes in high responders (≥12 oocytes retrieved) according to the controlled ovarian stimulation protocol (COS) used.

Methods

Clinical retrospective evaluation of total, clinical pregnancy and implantation rates in ART cycles performed in high responders according to the COS protocol used (long or antagonist) at Pathophysiology Unit of Human Reproduction and Sperm Bank of Pordenone from June 2000 to December 2010.

Results

In high responders total, clinical and implantation rates were significantly higher in long if compared with antagonist protocol with peak estradiol level ≤3,000 pg/ml; on the contrary there was a significantly higher implantation rate with antagonist than long protocol with peak estradiol >3,000 pg/ml. However in this subgroup of patients total and clinical pregnancy rates showed only a trend favouring antagonist possibly due to a statistical β error.

Conclusions

In high responders long protocol seems to work better than antagonist when peak E2 is lower than 3,000 pg/ml but the opposite may be true for cycles with higher E2 levels.

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Conflicts of Interest

Authors do not declare any conflict of interest.

Financial support

There were no financial supports to the study.

Author information

Authors and Affiliations

  1. Pathophysiology Unit of Human Reproduction and Sperm Bank, Mother and Child Department, Pordenone Hospital, Azienda S. Maria degli Angeli, via Montereale 24, 33170, Pordenone, Italy

    Massimo Manno, Marta Cervi, Donatella Zadro, Giuseppa Fuggetta & Francesco Tomei

  2. Obstetric and Gynecology Unit, Mother and Child Department, Pordenone Hospital, Azienda S. Maria degli Angeli, via Montereale 24, 33170, Pordenone, Italy

    Valter Adamo

Authors
  1. Massimo Manno
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  2. Marta Cervi
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  3. Donatella Zadro
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  4. Giuseppa Fuggetta
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  5. Valter Adamo
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  6. Francesco Tomei
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Corresponding author

Correspondence to Massimo Manno.

Additional information

Capsule

High estradiol levels could impair endometrial receptivity. Our retrospective data seem to suggest that antagonist use can prevent this detrimental endometrial effect in high responders (≥12 oocytes retrieved).

The study was not previously presented in any meeting or congress.

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Manno, M., Cervi, M., Zadro, D. et al. Different ART outcomes at increasing peak estradiol levels with long and antagonist protocols: retrospective insights from ten years experience. J Assist Reprod Genet 28, 693–698 (2011). https://doi.org/10.1007/s10815-011-9570-4

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  • DOI: https://doi.org/10.1007/s10815-011-9570-4

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