| 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? | |
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MedLine Citation:
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PMID: 19671625 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The purpose of this prospective observational study was to evaluate the association between estradiol (E(2)) levels on the day of human chorionic gonadotrophin (hCG) administration and pregnancy rates in a recombinant FSH (rec-FSH) antagonist fixed protocol. METHODS: A group of 207 patients (<or=39 years of age), treated by IVF/ICSI, received 200 IU/day rec-FSH from Day 2 of the cycle and daily GnRH antagonist starting on Day 6 of stimulation. The criteria for hCG administration included only the presence of >or=3 follicles of >or=17 mm diameter. One to two embryos were transferred on Day 3 after oocyte retrieval. RESULTS: The area under the curve (AUC) for E(2) on the day of hCG could not distinguish between pregnant and non-pregnant women (AUC:0.5; 95% confidence interval (CI): 0.42-0.59). No significant difference was observed between the three percentile groups of E(2) values on the day of hCG administration [group 1, lower 25th percentile (<1142 pg/ml); group 2, medium 50th percentile (1142-2446 pg/ml) and group 3, higher 75th percentile (>2446 pg/ml)] for the ongoing pregnancy rates (P = 0.52). On the contrary, the linear regression model showed that higher E(2) values on the day of hCG administration significantly improved the scores of transferred embryos (P = 0.01) as well as the total embryo score (P = 0.02). Yet subgroup analysis only in this high responders group revealed lower E(2) and progesterone levels on the day of hCG in pregnant women compared with the non-pregnant (P = 0.01). CONCLUSIONS: E(2) concentrations on the day of hCG administration in GnRH antagonist cycles are not associated with pregnancy rates. A potential deleterious impact of estradiol on endometrial receptivity is shown for the high responders who have high E(2) levels and improved embryo quality without a concomitant rise in pregnancy rate. |
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Authors:
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D Kyrou; B Popovic-Todorovic; H M Fatemi; C Bourgain; P Haentjens; L Van Landuyt; P Devroey |
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Publication Detail:
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Type: Journal Article Date: 2009-08-11 |
Journal Detail:
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Title: Human reproduction (Oxford, England) Volume: 24 ISSN: 1460-2350 ISO Abbreviation: Hum. Reprod. Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-10-19 Completed Date: 2010-02-18 Revised Date: 2010-02-19 |
Medline Journal Info:
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Nlm Unique ID: 8701199 Medline TA: Hum Reprod Country: England |
Other Details:
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Languages: eng Pagination: 2902-9 Citation Subset: IM |
Affiliation:
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Centre for Reproductive Medicine, Dutch-Speaking Free University Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium. mimikyrou@yahoo.gr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Chorionic Gonadotropin / pharmacology* Embryo Transfer Estradiol / blood* Female Fertilization in Vitro Follicle Stimulating Hormone / pharmacology* Gonadotropin-Releasing Hormone / antagonists & inhibitors* Humans Linear Models Pregnancy Pregnancy Rate Prospective Studies Recombinant Proteins / pharmacology* |
| Chemical | |
Reg. No./Substance:
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0/Chorionic Gonadotropin; 0/Recombinant Proteins; 33515-09-2/Gonadotropin-Releasing Hormone; 50-28-2/Estradiol; 9002-68-0/Follicle Stimulating Hormone |
| Comments/Corrections | |
Comment In:
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Hum Reprod. 2010 Mar;25(3):809-10; author reply 810
[PMID:
20085910
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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