2010, Number 10
<< Back Next >>
Ginecol Obstet Mex 2010; 78 (10)
Influence of the high peak serum estradiol on the outcome of in vitro fertilization cycles
Carmona-Ruiz IO, Galache-Vega P, Santos-Haliscak R, Díaz-Spíndola P, Batiza-Reséndiz VA, Hernández-Ayup S
Language: Spanish
References: 23
Page: 553-558
PDF size: 237.23 Kb.
ABSTRACT
Background: For the use of assisted reproductive technologies of high complexity (IVF-ET and ICSI) is essential to proper ovarian stimulation with recombinant FSH drugs menotropins, as well as the use of GnRH analogues.
Objective: To correlate serum estradiol level on day 10
th with the outcome of
in vitro fertilization cycles.
Material and method: Retrospective study of 523 IVF cycles, selected and analyzed from 2005 to 2009. Patients underwent individualized stimulation protocols with gonadotropins and agonist (late luteal phase). The patients were divided into three groups according with the serum level of estradiol on day 10
th of stimulation: Group I, patients with serum level of Estradiol below 1,000 pg/mL; Group II, with levels between 1,000-4,000 pg/mL; and Group III, with levels above 4,000 pg/mL. Peak serum estradiol levels, oocyte number, fertilization rates, implantation rates, and pregnancy rates were compared among groups.
Results: The fertilization rate was 62.8 in Group I; 60.6% in Group II, and 54.2% in Group III. The pregnancy rate in Group I was 29.8%; in Group II, 37.3%; and 24% for Group III. The implantation rates were 14, 22 and 14% for each group respectively (I, II and III).
Conclusions: There is an inverse relationship between high peak serum estradiol levels and pregnancy rate; the implantation rate seems affected by the extreme levels of serum estradiol. The percent of total mature oocytes and fertilization rate improve with serum levels of estradiol at physiologic values.
REFERENCES
Hernández Ayup S, Batiza Resendiz VA. La Reproducción Asistida: Presente y Futuro. Programa de Actualización Continua en Ginecología y Obstetricia Libro 2.
Fauser BCJM, Devroey P, Yen SSC. Minimal ovarian stimulation for IVF: appraisal of potential benefits and drawbacks. Hum Reprod 1999;14:2681-2686.
Kably AA. Estévez GS. Estradiol sérico el día de la administración de hCG como factor pronóstico de fertilización in vitro con transferencia de embriones. Ginecol Obstet Mex 2008;76(4):197-201.
García JE, Acosta AA, Hsiu JG, Jones HW. Advanced Endometrial Maturation after Ovulation Induction with human menopausal gonadotrophin/human chorionic gonadotrophin for in vitro fertilization. Fertil Steril 1984;41:31-37.
Bladford AJ, Najmabadi S, Paulson RJ. Ultrastructural characteristics of the luteal phase endometrium in donors undergoing controlled ovarian hyperstimulation. Fertil Steril 1997;67:625-630.
Gidley-Baird AA, O’Neil C, Sinosich MJ, et al. Failure of implantation in human in vitro fertilization and embryo transfer patients: the effects of altered progesterone/estrogen rations in human and mice. Fertil Steril 1986;45:69-75.
Valbuena D, Martin C, De Paplo JL, Ramohi J, et al. Increasing levels of oestradiol are deleterious to embryonic implantationbecause they directly affect the embryo. Fertil Esteril 2001;76:962-968.
Testart J, Belaisch-Allart J, Frydman R. Relationship between embryo transfer results and ovarian response and in vitro fertilization rates: analysis of 186 human pregnancies. Fertil Steril 1986;45:237-243.
Pellicer A, Valbuena D, Cano F, et al. Lower implantation rates in high responders: evidence for an altered endocrine milieu during the preimplantation period. Fertil Steril 1996;65:1190-1195.
Simón C, Garcia Velasco J, Valbuena D, et al. Increased uterine receptivity by decreasing E2 levels during the preimplantationperiod in high responders with the use of a follicle-stimulating hormone step-down regimen. Fertil Steril 1998;70:234-239.
Van Blerkom J, Antczak M, Schrader R. The developmental potential of the human oocyte is related to the dissolved oxygen content of follicular fluid: association with vascular endothelial growth factor levels and perifollicular blood flow characteristics. Hum Reprod 1997;12:1047-1055.
Mendoza C, Cremades N, Ruiz-Requena E, Martinez F, et al. Relationship between fertilization results after intracytoplasmicsperm injection, and intrafollicular steroid, pituitary hormone and cytokine concentrations. Hum Reprod 1999;14:628-635.
Teissier MP, Chable H, Paulhac S, Aubard Y. Comparison of follicle steroidogenesis from normal and polycystic ovaries in women undergoing IVF: relationship between steroid concentrations, follicle size, oocyte quality and fecundability. Hum Reprod 2000;15:2471-2477.
Galache Vega P, Saucedo de la Llata E, Moraga Sánchez MR, Pezino RJA, et al. Pronóstico del índice estradiol-óvulo en la inyección intracitoplasmática de espermatozoides (ICSI). Ginecol Obstet Mex 2003;71:600-604.
Saucedo de la Llata E, Moraga Sánchez MR, Pezino RJA, Treviño RA, et al. Altas concentraciones de estradiol sérico en reproducción asistida. Ginecol Obstet Mex 2003;71:585-589.
Kosmas IP, Kolibianakis EM, Devroey P. Association of estradiol levels on the day of hCG administration and pregnancy achievement in IVF: a systematic review. Hum Reprod 2004;(19):2446-2453.
Andersen CY. Characteristics of human follicular fluid associated with successful conception after in vitro fertilization. J Clin Endocrinol Metab 1993;77:1227-1234.
Fukuda M, Fukuda K, Yding Andersen C, Byskov AG. Healthy and atretic follicles: vaginosonographic detection and follicular fluid hormone profiles. Hum Reprod 1995;10:1633-1637.
Schmidt A, Hahn S, White L, Russell D, et al. High peak serum estradiols during IVF-ET impair pregnancy and implantation rates. Fertil Steril 2004;(82).
Simon C, Cano F, Valbuena D, Remohi J, Pellicer A. Clinical evidence for a detrimental effect on uterine receptivity of hogh serum E2 concentrations in hogh and normal responder patients. Hum Reprod 1995;10:2432-2437.
Yu Ng EH, Yeung WS, Yee Lan Lau E, So WW, Ho PC. High serum E2 concentrations in fresh IVF cycles do not impair implantation and pregnancy rates in subsequent frozen-thawed embryo transfer cycles. Hum Reprod 2000;(15):250-255.
Papageorgiou T, Guibert J, Goffinet F, Patrat C, et al. Percentile curves of serum estradiol levels during controlled ovarian stimulation in 905 cycles stimulated with recombinant FSH show that high estradiol is not detrimental to IVF outcome. Hum Reprod 2002;(17):2846-2850.
Rosen MP, Zamah AM, Shen S, Dobson AT, et al. The effect of follicular fluid hormones on oocyte recovery after ovarian stimulation: FSH level predicts oocyte recovery. Reproductive Biology and Endocrinology 2009;7:35.