Estradiol production during controlled ovarian hyperstimulation correlates with treatment outcome in women undergoing in vitro fertilization–embryo transfer

ObjectiveTo study the value of E2 production during controlled ovarian hyperstimulation (COH) in predicting IVF-ET outcome.DesignHistorical cohort.SettingAcademic infertility center.Patient(s)A cohort of 270 patients who completed 324 consecutive IVF-ET treatment cycles.Intervention(s)None.Main Outcome Measure(s)Area under the curve for E2 levels (AUC-E2) from the first day of COH until the day of hCG administration was calculated and cycles grouped into low, average, and high AUC-E2 groups. Clinical pregnancy rates per cycle were compared among the three groups, and correlations with AUC-E2 values were calculated for all patients and after sub-grouping according to age, COH protocol and infertility diagnosis.Result(s)Cycles with low and high AUC-E2 values had significantly lower pregnancy rates particularly in patients 35 years or older. There was a positive correlation between AUC-E2 and pregnancy rates up to a certain AUC-E2 level above which a negative correlation was found. The turning point between positive and negative correlations occurred at a significantly lower AUC-E2 level in patients 35 years or older.ConclusionsEstradiol production during COH correlates with IVF-ET outcome. Women >35 years of age seem more vulnerable to high E2 levels.