Document Detail

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?
MedLine Citation:
PMID:  19671625     Owner:  NLM     Status:  MEDLINE    
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.
D Kyrou; B Popovic-Todorovic; H M Fatemi; C Bourgain; P Haentjens; L Van Landuyt; P Devroey
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Publication Detail:
Type:  Journal Article     Date:  2009-08-11
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  24     ISSN:  1460-2350     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-19     Completed Date:  2010-02-18     Revised Date:  2010-02-19    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  2902-9     Citation Subset:  IM    
Centre for Reproductive Medicine, Dutch-Speaking Free University Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium.
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MeSH Terms
Chorionic Gonadotropin / pharmacology*
Embryo Transfer
Estradiol / blood*
Fertilization in Vitro
Follicle Stimulating Hormone / pharmacology*
Gonadotropin-Releasing Hormone / antagonists & inhibitors*
Linear Models
Pregnancy Rate
Prospective Studies
Recombinant Proteins / pharmacology*
Reg. No./Substance:
0/Chorionic Gonadotropin; 0/Recombinant Proteins; 33515-09-2/Gonadotropin-Releasing Hormone; 50-28-2/Estradiol; 9002-68-0/Follicle Stimulating Hormone
Comment In:
Hum Reprod. 2010 Mar;25(3):809-10; author reply 810   [PMID:  20085910 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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