P-23: Peak Follicular Estradiol Levels and Its Significance in Predicting Pregnancy Outcomes

Abstract

Objectives: To determine the influence of peak follicular estradiol levels on pregnancy outcomesMethods: 80 completed cycles of patients undergoing IVF-ET with controlled ovarian hyperstimulation (COH) were analyzed. Patients underwent standard protocols using gonadotropins and embryo transfer was done on day 3 or day 5 after oocyte retrieval. Estradiol levels were drawn throughout the follicular phase when the patient had sonographic evaluation to evaluate ovarian response. Biochemical pregnancy was confirmed by a serum HCG drawn 14 days after embryo transfer. Clinical pregnancy was confirmed sonographically by evidence of embryonic heartbeat. Chi square analysis was used to assess any difference in pregnancy outcomes based on peak estradiol levels. Paired student t-test was used to compare the difference in peak estradiol levels of pregnant and nonpregnant cycles. Pearson’s correlation was used to correlate peak estradiol levels with the number of eggs retrieved, the number of eggs fertilized, and the fertilization rate.Results:Tabled 1Mean peak estradiol ± Std (pg/ml)PregnantNon-pregnantP valueBiochemical pregnancies2941 ± 12002818 ± 1988.76Clinical pregnancies2884 ± 11952860 ± 1679.96 Open table in a new tab Figure 2View Large Image Figure ViewerDownload (PPT)Tabled 1<1000>1000Pregnant229Nonpregnant1237Chi square = 4.27p-value = .04<2000>2000Pregnant526Nonpregnant1930Chi square = 4.64p-value = .03 Open table in a new tab This difference, however, was not present when comparing peak estradiol levels to clinical pregnancies.Conclusion: 1Higher estradiol levels during the follicular phase of IVF-ET cycles correlate with increased number of eggs retrieved and fertilized.2Fertilization rates, however, are negatively correlated with peak estradiol levels. This may be explained by the possibility of more immature oocytes with increasing estradiol levels.3As a result of the above two conclusions, no difference exists between peak estradiol levels in pregnant and nonpregnant cycles4When stratified by estradiol levels <2000 and >2000, there is a significant difference in the number of biochemical pregnancies achieved. This difference does not continue on to the number of clinical pregnancies. Objectives: To determine the influence of peak follicular estradiol levels on pregnancy outcomes Methods: 80 completed cycles of patients undergoing IVF-ET with controlled ovarian hyperstimulation (COH) were analyzed. Patients underwent standard protocols using gonadotropins and embryo transfer was done on day 3 or day 5 after oocyte retrieval. Estradiol levels were drawn throughout the follicular phase when the patient had sonographic evaluation to evaluate ovarian response. Biochemical pregnancy was confirmed by a serum HCG drawn 14 days after embryo transfer. Clinical pregnancy was confirmed sonographically by evidence of embryonic heartbeat. Chi square analysis was used to assess any difference in pregnancy outcomes based on peak estradiol levels. Paired student t-test was used to compare the difference in peak estradiol levels of pregnant and nonpregnant cycles. Pearson’s correlation was used to correlate peak estradiol levels with the number of eggs retrieved, the number of eggs fertilized, and the fertilization rate. Results: This difference, however, was not present when comparing peak estradiol levels to clinical pregnancies. Conclusion: 1Higher estradiol levels during the follicular phase of IVF-ET cycles correlate with increased number of eggs retrieved and fertilized.2Fertilization rates, however, are negatively correlated with peak estradiol levels. This may be explained by the possibility of more immature oocytes with increasing estradiol levels.3As a result of the above two conclusions, no difference exists between peak estradiol levels in pregnant and nonpregnant cycles4When stratified by estradiol levels <2000 and >2000, there is a significant difference in the number of biochemical pregnancies achieved. This difference does not continue on to the number of clinical pregnancies.