Pregnancy rate in relation to number of cleaved eggs replaced after in-vitro fertilization in stimulated cycles monitored by serum levels of oestradiol and progesterone as sole index.

Abstract

A simple model for monitoring ovarian stimulation in in-vitro fertilization cycles was designed using daily serum levels of 17 beta-oestradiol and progesterone as the only index to determine the day of ovum retrieval. Human chorionic gonadotropin was administered in the evening 2 days after a level of 2500 pmol/l oestradiol in serum was exceeded provided the serum progesterone level was less than 5 nmol/l. Ovarian stimulation was initiated in 128 women scheduled for laparoscopic oocyte retrieval. Twelve cycles (9%) were cancelled before ovum pick up due to sub-optimal hormone levels in serum and five for other reasons. In 107 successful laparoscopies, 616 oocytes (mean 5.8 per laparoscopy) were recovered. The cleavage rate after IVF was 65% in the egg replacement group. In 87 women, a total of 271 cleaved eggs (range 1-6, mean 3.1) were replaced. The most important factor for establishing a pregnancy was the number of eggs replaced at the same time. Clinical pregnancies were achieved after 30% of replacements, increasing to 50% after replacement of 5-6 eggs. The ongoing/delivered pregnancy rate after the 18th week of gestation was 69%. It was concluded that the simple monitoring model used was consistent with a high pregnancy rate and a low rate of cancelled cycles.