The Effect of Serum Estradiol Level at the Time of HCG Injection on the ICSE Outcome

Abstract

Background: In addition to multi-follicular development, controlled stimulation of ovaries is associatedwith a high serum level of estradiol (E2). The increased serum E2 level during COS may therefore beassociated either with an increased chance of pregnancy or an impaired reproductive outcome secondary tochanged endometrial receptivity.Objective: To assess the effect of serum estradiol level at the day of hCG administration on the success ofintracytoplasmic sperm injection (ICSI) cyclesPatients and Method: A retrospective study, in which a total of 235 women who were undergo a singleICSI cycle were introduced in this retrospective study, All patients were received gonadotrophin agonisteither short or long protocol. The patients were classified at the day of hCG administration into three groupsaccording to serum E2 level group A <1000pg/ml, group B 1000-3000pg/ml and group C >3000pg/ml.Results: The mean number of retrieved oocytes and embryos obtained in group C were more than in groupA and B but clinical pregnancy rate was higher in group B than in group A and group C which is statisticallysignificant.Conclusion: Although there is no high quality evidence to support a positive correlation between serum E2levels and IVF-ICSI products, the E2 level in the serum may has a level –dependent effect on the successof pregnancy. The optimal range of serum E2 is 1000-3000pg/ml is associated with higher rate of clinicalpregnancy