Impact of Estradiol Monitoring on the Prediction of Intrauterine Insemination Outcome

Abstract

ABSTRACT Purpose To evaluate the predictive value of estradiol levels on the day of human chorionic gonadotropin (hCG) administration on intrauterine insemination success rate. Materials and methods The present study included 200 intrauterine insemination (IUI) cycles performed between June 2011 and October 2012. All IUI cycles were preceded by ovarian stimulation with gonadotropins starting on cycle day 3. A single IUI was performed 24 to 36 hours after hCG administration. Binary logistic regression analysis was performed to define the covariates of IUI success. The main outcome measure, the clinical pregnancy rate per cycle, was assessed according to the estradiol level. Results With LR ± 2 and AUC=0.73, ROC analysis revealed out the estradiol level as 465 pg/ml to predict the pregnancy with 60% sensitivity and 66% specificity. Binary logistic regression analysis identified the presence of estradiol levels higher than 465 pg/ml (p < 0.01, 95% CI = 0.147 – 0.687) and stimulation duration (p < 0.01, 95% CI = 0.201 – 0.705) as the covariates approached statistical significance for IUI success. Conclusion Estradiol level >465 pg/ml on the day of hCG administration might point out advanced outcome on mild ovarian stimulation combined with insemination. How to cite this article Atilgan R, Ekinci M, Sapmaz E, Ozkan ZS. Impact of Estradiol Monitoring on the Prediction of Intrauterine Insemination Outcome. Int J Infertility Fetal Med 2013;4(3):88-92.