Clin Exp Reprod Med.
2020 Sep;47(3):213-220. 10.5653/cerm.2019.03419.
Do spontaneously decreasing estradiol levels prior to triggering of ovulation adversely impact in vitro fertilization outcomes?
- Affiliations
-
- 1Department of Obstetrics and Gynecology and Infertility, Barzilai University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev Ashkelon, Israel
- 2Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- 3Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- 4Department of Obstetrics and Gynecology, Wolfson Maternity Hospital, Wolfson Medical Center, Holon, Israel
- KMID: 2506147
- DOI: http://doi.org/10.5653/cerm.2019.03419
Abstract
Objective
The aim of this study was to explore the potential adverse effect of spontaneously decreasing serum estradiol (SE) levels on in vitro fertilization (IVF) outcomes.
Methods
This retrospective single-subject study analyzed IVF cycles conducted at a hospital IVF unit between 2010 and 2017. Overall, 2,417 cycles were analyzed. Only cycles with spontaneously decreasing SE before human chorionic gonadotropin (hCG) triggering were included. Each patient served as her own control, and subsequent cycles were analyzed for recurrent SE decreases. The main outcome was the number of oocytes retrieved.
Results
Cycle characteristics were similar between the study (SE decrease) and control groups, with the exception of the median SE on the day of hCG triggering (899.7 pg/mL; interquartile range [IQR], 193–2,116 pg/mL vs. 1,566.8 pg/mL; IQR, 249–2,970 pg/mL; p <0.001). The study group, relative to the control group, had significantly fewer total oocytes (5 [IQR, 2–9] vs. 7 [IQR, 3–11]; p=0.002) and significantly fewer metaphase II (MII) oocytes (3 [IQR, 1–6] vs. 4 [IQR, 2–8]; p=0.001) retrieved. The study group had fewer cleavage-stage embryos than the control cycles (3 [IQR, 1–6] vs. 4 [IQR, 2–7]; p=0.012). Compared to cycles with a ≤20% SE decrease, cycles with a >20% decrease had significantly fewer total and MII oocytes retrieved. SE decrease recurred in 12% of patients.
Conclusion
A spontaneous decrease in SE levels adversely affected IVF outcomes, with a linear correlation between the percentage decrease and the number of oocytes retrieved. SE decrease can repeat in later cycles.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Transabdominal follicular aspiration in an in vitro fertilization cycle: experiences with an unusual but necessary intervention in a resource-limited setting
- Serum Anti-Mullerian Hormone and Inhibin B Levels at Ovulation Triggering Day Can Predict the Number of Immature Oocytes Retrieved in In Vitro Fertilization Cycles
- Factors influencing serum progesterone level on triggering day in stimulated in vitro fertilization cycles
- Effects of super high serum estradiol levels on in vitro fertilization outcome
- Cessation of gonadotropin-releasing hormone antagonist on triggering day in flexible multiple-dose protocol: A randomized controlled study
