Skip to main content
SpringerLink
Log in

Serum Estradiol as a Predictor of Success of In Vitro Fertilization

  • Original Article
  • Published:
The Journal of Obstetrics and Gynecology of India Aims and scope Submit manuscript

Abstract

Aim

The aim of this study was to assess the role of total serum estradiol on the day of injection HCG, estradiol per mature follicle, and estradiol per oocytes retrieved (OR) on clinical pregnancy rate (CPR) and oocyte/embryo quality in assisted reproduction.

Materials and Methods

A retrospective review of 342 in vitro fertilization cycles with normal ovarian reserve in women who underwent long GnRH agonist protocol was included. The outcomes assessed are number of OR, number of mature oocytes (MO), number of oocytes fertilized (FO), fertilization rate, number of embryos cleaved (EC), cleavage rate (CR), number of Grade I embryos (E), number of cryopreserved embryos (CPE), and CPR. The Estradiol/follicle ratio (E2/fol) was defined as estradiol level per mature follicle >14 mm in diameter. Estradiol/oocyte (E2/O) ratio was defined as estradiol level per OR. These two ratios were categorized by the 25th percentile into four groups.

Results

A positive correlation was seen between E2/fol and OR (r = .334, p value = .0001), MO (r = .335, p value = .0001), FO (r = .222, p value = .002), and CPE (r = .289, p value = .0001). Increased CPR was seen in Group C (E2/fol = 200–299.99) compared to Group A, B, and D (p value = .033). With E2/O ratio, negative correlation was seen between E2/O and OR (r = −.281, p value = .002), MO (r = −.296, p value = .008), FO (r = −.220, p value = .003), EC (r = −.211, p value = .004), Grade 1 embryo (r = −.216, p value = .001), and CPE (r = −.206, p value = .005). No difference in FR, CR, or CPR was seen. No difference was seen in CPR with total serum estradiol.

Conclusions

In conclusion, serum estradiol is an important determinant of IVF success. While total serum estradiol does not exert any positive or negative influence on IVF outcome, estradiol per mature follicle and retrieved oocytes do have an impact. Pregnancy rate is better when E2/fol is between 200 and 299.99 pg/ml. Also, increasing serum E2/fol positively correlates with better oocytes and embryo quality. In contrast, E2/O negatively correlates with oocytes and embryo quality parameters.

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

Similar content being viewed by others

References

  1. Anifandis G, Koutselini E, Louridas K, et al. Estradiol and leptin as conditional prognostic IVF markers. Reproduction. 2005;129:531–4.

    Article  CAS  PubMed  Google Scholar 

  2. Kosmas IP, Kolibianakis EM, Devroey P. Association of estradiol levels on the day of hCG administration and pregnancy achievement in IVF: a systematic review. Hum Reprod. 2004;19:2446–53.

    Article  CAS  PubMed  Google Scholar 

  3. Chenette PE, Sauer MV, Paulson RJ. Very high serum estradiol levels are not detrimental to clinical outcome of in vitro fertilization. Fertil Steril. 1990;54:858–63.

    CAS  PubMed  Google Scholar 

  4. Sharara FI, McClamrock HD. High estradiol levels and high oocyte yield are not detrimental to in vitro fertilization outcome. Fertil Steril. 1999;72:401–5.

    Article  CAS  PubMed  Google Scholar 

  5. Simon C, Cano F, Valbuena D, et al. Implantation; clinical evidence for a detrimental effect on uterine receptivity of high serum oestradiol concentrations in high and normal responder patients. Hum Reprod. 1995;10:2432–7.

    Article  CAS  PubMed  Google Scholar 

  6. Kolibianakis EM, Venetis CA, Tarlatzis BC. Role of endocrine profile for the achievement of pregnancy with IVF. Reprod Biomed Online. 2009;18:37–43.

    Article  PubMed  Google Scholar 

  7. Sharara FI, McClamrock HD. Ratio of oestradiol concentration is predictive of in vitro fertilization outcome. Hum Reprod. 1999;14:2777–82.

    Article  CAS  PubMed  Google Scholar 

  8. Phelps JY, Levine AS, Hickman TN, et al. Day 4 estradiol levels predict pregnancy success in women undergoing controlled ovarian hyperstimultion for IVF. Fertil Steril. 1998;69:1015–9.

    Article  CAS  PubMed  Google Scholar 

  9. Pena JE, Chang PL, Chan LK, et al. Supraphysiological estradiol levels do not affect oocyte and embryo quality in oocyte donation cycles. Hum Reprod. 2002;17:83–7.

    Google Scholar 

  10. Yu Ng EH, Biu Yeung WS, Yee Lan Lau E, et al. High serum oestradiol concentrations in fresh IVF cycles do not impair implantation and pregnancy rates in subsequent frozen-thawed embryo transfer cycles. Hum Reprod. 2000;15:250–5.

    Article  CAS  PubMed  Google Scholar 

  11. Orvieto R, Zohav E, Scharf S, et al. The influence of estradiol/follicle and estradiol/oocyte ratios on the outcome of controlled ovarian stimulation for in vitro fertilization. Gynecol Endocrinol. 2007;23:72–5.

    Article  CAS  PubMed  Google Scholar 

  12. Tesarik J, Mendoza C. Nongenomic effects of 17 beta-estradiol on maturing human oocytes: relationship to oocyte developmental potential. J Clin Endocrinol Metab. 1995;80:1438–43.

    CAS  PubMed  Google Scholar 

  13. Loutradis D, Beretsos P, Arabatzi E, et al. The role of steroid hormones in ART. J Steroid Biochem Mol Biol. 2008;112:1–4.

    Article  CAS  PubMed  Google Scholar 

  14. Papageorgiou T, Guibert J, Goffinet F, et al. Percentile curves of serum estradiol levels during controlled ovarian stimulation in 905 cycles stimulated with recombinant FSH show that high estradiol. Hum Reprod. 2007;17(11):2846–50.

    Article  Google Scholar 

  15. Ozdegirmenci O, Dilbaz S, Cinar O, et al. Can serum oestradiol be a predictor of quality of oocytes and embryos, maturation of oocytes and pregnancy rate in ICSI cycles. Gynecol Endocrinol. 2011;27(4):279–85.

    Article  CAS  PubMed  Google Scholar 

  16. Ng EH, Lau EY, Yeung WS, et al. Oocyte and embryo quality in patients with excessive ovarian response during in vitro fertilization treatment. J Assist Reprod Genet. 2003;20:186–91.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Pena J, Chang PL, Chan LK, et al. Supraphysiological estradiol levels do not affect oocyte and embryo quality in oocyte donation cycle. Hum Reprod. 2002;17:83–7.

    Google Scholar 

  18. Yang JH, Chen HF, Lien YR, et al. Elevated E2: oocyte ratio in women undergoing IVF and tubal ET. J Reprod Med. 2001;46:434–8.

    CAS  PubMed  Google Scholar 

  19. Kyrou D, Popovic-Todorovic B, Fatemi HM, et al. 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. 2009;24:2902–9.

    Article  CAS  PubMed  Google Scholar 

  20. Joo BS, Park SH, An BM, et al. Serum estradiol levels during controlled ovarian hyperstimulation influence the pregnancy outcome of in vitro fertilization in a concentration-dependent manner. Fertil Steril. 2010;93:442–6.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India

    Suneeta Mittal (Professor), Prerna Gupta (Senior Research associate), Neena Malhotra (Additional Professor) & Neeta Singh (Additional Professor)

Authors
  1. Suneeta Mittal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Prerna Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Neena Malhotra
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Neeta Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Prerna Gupta.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mittal, S., Gupta, P., Malhotra, N. et al. Serum Estradiol as a Predictor of Success of In Vitro Fertilization. J Obstet Gynecol India 64, 124–129 (2014). https://doi.org/10.1007/s13224-013-0470-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13224-013-0470-7

Keywords

Search

Navigation