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The effects of peak and mid-luteal estradiol levels on in vitro fertilization outcome

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

Abstract

Purposes

To evaluate the role of peak E2 level and its ratio to mid-luteal E2 level on implantation and clinical pregnancy rates in patients undergoing IVF cycles.

Methods

A retrospective study was designed covering 106 patients who were admitted to IVF Unit between June and October 2008. The patients were divided into two groups with respect to peak E2 levels. Ovulation induction has been done via standard long agonist protocol. Blood samples were drawn on the day of (hCG) administration and 8 days after embryo transfer for serum E2, progesterone measurements.

Results

The mean peak E2 level was 2,697.4 ± 1,453 pg/ml (range 684–4,983 pg/ml. The number of retrieved oocytes, luteal E2 level, peak E2 level and E2 ratio were significantly higher in E2 >2,500 group, however, the implantation rate was significantly lower in this group.

There were statistically significant differences in peak E2 levels, luteal E2 levels, retrieved oocytes, E2 ratios; of the women who got pregnant and did not get pregnant, all the above parameters were significantly higher in non-pregnant group. According to E2 ratios, the clinical pregnancy rate was highest in group 1 and significantly lowest in group 3.

Conclusion

This study has shown that the high E2 level and mid-luteal decline of E2 which were defined as peak E2 level/mid-luteal E2 level were predictive for implantation rate in IVF cycles.

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References

  1. 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 11:2446–2453

    Article  Google Scholar 

  2. Hung EYN, Yeung WSB, Lau EYL, So WWK, Ho PC (2000) A rapid decline in serum oestradiol concentrations around the mid-luteal phase had no adverse effect on outcome in 763 assisted reproduction cycles. Hum Reprod 9:1903–1908

    Article  Google Scholar 

  3. Sharara FI, McClamrock HD (1999) Ratio of oestradiol concentration on the day of human chorionic gonadotrophin administration to mid-luteal oestradiol concentration is predictive of in vitro fertilization outcome. Hum Reprod 11:2777–2782

    Article  Google Scholar 

  4. Hung EYN, Yeung WSB, Lau EYL, So WWK, Ho PC (2000) High serum oestradiol 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  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  6. Inge GB, Brinsden PR, Elder KT (2005) Oocyte number per live birth in IVF: were Steptoe and Edwards less wasteful? Hum Reprod 20:588–592

    Article  PubMed  Google Scholar 

  7. Simon C, Garcia Velasco JI, Valbuena D, Peinado JA, Moreno C et al (1998) Increasing uterine receptivityby decreasing oestradiol levels during the preimplantation period in high responders with the use of a follicle stimulating hormone step-down regimen. Fertil Steril 70:234–239

    Article  PubMed  CAS  Google Scholar 

  8. Pellicer A, Valbuena D, Cono F, Remohi J, Simon C (1996) Lower implantation rates in high-responders: evidence for an altered endocrine milieu during the preimplantation period. Fertil Steril 65:1190–1195

    PubMed  CAS  Google Scholar 

  9. Pellicer A, Simon C, Castellui RM, Colatayud C, Ruiz A, Ruiz M et al (1989) Is the retrieval of high numbers of oocytes desirable in patients treated with gonadotrophin-releasing hormone anologues and gonadotrophins? Hum Reprod 4:536–540

    PubMed  CAS  Google Scholar 

  10. Valbuena D, Martin J, de Pablo JL, Remohi J, Pellicer A, Simon C (2001) Increasing levels of E2 are deleterious to embryonic implantation because they directly affect the embryo. Fertil Steril 76:962–968

    Article  PubMed  CAS  Google Scholar 

  11. Bianco K, Mahutte NG, Arici A, Sakkas D, Taylor HS (2009) Effect of estradiol on oocyte development. Int J Gynaecol Obstet 104(3):230–232

    Article  PubMed  CAS  Google Scholar 

  12. Toner JP, Brzyski RG, Oehninger S, Veeck LL, Simonetti S, Muasher SJ (1991) Combined impact of the number of pre-ovulatory oocytes and cryopreservation on IVF outcome. Hum Reprod 6:284–289

    PubMed  CAS  Google Scholar 

  13. Sharara FI, McClamrock HD (1999) High oestradiol levels and high oocyte yield are not detrimental to in vitro fertilization outcome. Fertil Steril 72(3):401–405

    Article  PubMed  CAS  Google Scholar 

  14. Gidley-Baired AA, O’ Neill C, Sinosich MJ, Porter RN, Pike IL, Sounders DM (1986) Failure of implantation in human in vitro fertilization and embryo transfer patients: the effects of altered progesterone/estrogen ratios in humans and mice. Fertil Steril 45:69–74

    Google Scholar 

  15. Testart J, Belaisch-Allart J, Frydman R (1986) Relationship between embryo transfer results and ovarian response and in vitro fertilization rates: analysis of 186 human pregnancies. Fertil Steril 45:237–243

    PubMed  CAS  Google Scholar 

  16. Tarin JJ, Sampaio MC, Colatayud C, Castellui RM, Bonilla-Musoles F, Pellicer A (1992) Relativity of the concept “high responder to gonadotrophins”. Human Reprod 7:19–22

    CAS  Google Scholar 

  17. Forman R, Fries N, Testart J, Belaisch-Allart J, Hazout A, Frydman R (1988) Evidence for an adverse effect of elevated serum estradiol concentrations on embryo implantation. Fertil Steril 49:118–122

    PubMed  CAS  Google Scholar 

  18. Makkar G, Ng EHY, Tang OS, Yeung WSB, Ho PC (2006) Reduced expression of Interleukin-11 and Interleukin-6 in the peri-implantation endometrium of excessive ovarian responders during in vitro fertilization treatment. J Clin Endocrinol Metab 91:3181–3188

    Article  PubMed  CAS  Google Scholar 

  19. Chen Q-J, Sun X–X, Li L, Gao X-H, Wu Y, Gemzell-Danielsson K, Cheng L-N (2007) Effects of ovarian high response on implantation and pregnancy outcome during controlled ovarian hyperstimulation (with GnRH agonist and rFSH). Acta Obstetricia et Gynecologica 86:849–854

    Article  CAS  Google Scholar 

  20. Var T, Tonguc E, Dogan M, Mollamahmutoğlu L (2010) Relationship between the oestradiol/oocyte ratio and the outcome of assisted reproductive technology cycles with gonadotropin releasing hormone agonist. Gynecol Endocrinol July 20 (Epub ahead of print)

  21. Ernest Hung Yu Ng (2000) What is the threshold value for serum estradiol levels associated with adverse IVF outcomes? [letter]. Fertil Steril 73:1071

    Article  Google Scholar 

  22. Wu C-H, Kuo T-C, Wu H-H, Yeh G-P, Tsai H-D (2007) High serum estradiol levels are not detrimental to in vitro fertilization outcome. Taiwan J Obstet Gynecol 46(1):54–59

    Article  PubMed  Google Scholar 

  23. Friedler S, Zimerman AL, Schachter M, Raziel A, Strassburger D, Ron El R (2002) The impact of peak follicular estradiol (E2) levels and its dramatic mid-luteal decline on the outcome of IVF-ET. Fertil Steril 78(1):52

    Article  Google Scholar 

  24. Friedler S, Zimerman A, Schachter M, Raziel A, Strassburger D, Ron El R (2005) The midluteal decline in serum estradiol levels is drastic but not deleterious for implantation after in vitro fertilization and embryo transfer in patients with normal or high responses. Fertil Steril 83(1):54–60

    Article  PubMed  Google Scholar 

  25. 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 93(2):442

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Reproductive Endocrinology, Zekai Tahir Burak Women’s Health Research and Education Hospital, Tunali Hilmi Cad. Binnaz Sok. No: 1/5 Kavaklidere, Ankara, 06100, Turkey

    Özlem Moraloğlu, Esra Ayşın Tonguc, Murat Özel, Gülnur Özakşit, Turgut Var & Esma Sarikaya

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  1. Özlem Moraloğlu
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  2. Esra Ayşın Tonguc
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  3. Murat Özel
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  4. Gülnur Özakşit
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  5. Turgut Var
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  6. Esma Sarikaya
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Correspondence to Esra Ayşın Tonguc.

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Moraloğlu, Ö., Tonguc, E.A., Özel, M. et al. The effects of peak and mid-luteal estradiol levels on in vitro fertilization outcome. Arch Gynecol Obstet 285, 857–862 (2012). https://doi.org/10.1007/s00404-011-2090-8

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  • DOI: https://doi.org/10.1007/s00404-011-2090-8

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