Day 4 Estradiol Levels Predict Pregnancy Success in Women Undergoing Controlled Ovarian Hyperstimulation for IVF

Phelps, John Y.; Levine, Adam Seth; Hickman, Timothy N.; Zacur, Howard A.; Wallach, Edward E.; Hinton, Endrika L.

doi:10.1016/s0015-0282(98)00059-4

Cited by 44 publications

(33 citation statements)

References 17 publications

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“…This study confirmed and expanded the findings from previous studies (Phelps et al, 1998;Dzik et al, 2000;Ravhon et al, 2000). A total of 57 patents undergoing their first cycle of long protocol IVF or introcytoplasmic sperm injection (ICSI) treatment were studied, and serum inhibin B, estradiol, FSH, LH levels were detected four times in the IVF cycle: on Day 3 of the menstrual cycle, before the first administration of Gn (Day 0), on Day 1 after Gn therapy, and on Day 5 after Gn therapy.…”

Section: Introductionsupporting

confidence: 92%

“…In fact, other studies proposed that the clinical response to Gn treatment would be a more direct way to assess ovarian reserve and a better predictor of fertility potential (Roest et al, 1996;Farhi et al, 1997;Peñar-rubia et al, 2000). Phelps et al(1998) found that the estradiol concentration measured on Day 4 of Gn therapy was highly predictive of successful ovulation induction and pregnancy outcome in GnRHa-rFSH cycles. This study confirmed previous studies and expanded some of their findings (Phelps et al, 1998;Ravhon et al, 2000;Dzik et al, 2000;Urbancsek et al, 2005b).…”

Section: Discussionmentioning

confidence: 93%

“…Recently, Phelps et al(1998) found that estradiol concentration obtained on Day 4 of Gn therapy was highly predictive of a successful ovulation induction and pregnancy outcome in IVF cycles. Neither observation of any variation of inhibin B nor measurement of baseline hormone values was mentioned in their study.…”

Section: Introductionmentioning

confidence: 99%

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Dynamic measurements of serum inhibin B and estradiol: apredictive evaluation of ovarian response to gonadotrophin stimulation in the early stage of IVF treatment

Miao

Huang

2009

J. Zhejiang Univ. Sci. B

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Abstract:Objective: We dynamically measured serum inhibin B and estradiol in the early stage of hormonal stimulation to predict the ovarian response in in vitro fertilization (IVF) treatment. Methods: A total of 57 patients (<40 years of age) who underwent the first cycle of long protocol IVF or introcytoplasmic sperm injection (ICSI) treatment were included. Serum inhibin B, estradiol, follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were measured four times: (1) on Day 3 of the menstrual cycle (basal); (2) on the day before the first administration of gonadotrophin (Gn) (Day 0); (3) on Day 1 of Gn therapy; and (4) on Day 5 of Gn therapy. Comparisons of these measurements with ovarian responses and pregnancy outcomes were made and analyzed statistically. Results: (1) On Day 1 and Day 5 of recombinant FSH (rFSH) stimulation, ovarian response, i.e., numbers of follicles, oocytes, fertilized oocytes, and embryos, had a positive correlation (r s =0.46~0.61, P=0.000) with raised inhibin B and estradiol concentrations, but a negative correlation (r s =−0.67~−0.38, P=0.000 or P<0.01) with total rFSH dose and total days of rFSH stimulation. (2) No significant variation (P>0.05) between the pregnant and non-pregnant groups on the basis of mean age or on all hormone concentrations at four times of the IVF cycle was observed. However, all the seven patients aged >35 years did not reach pregnancy. Conclusions: (1) Serum inhibin B and estradiol concentrations obtained shortly after Gn therapy may offer an accurate and early prediction of ovarian response; (2) Low levels of serum inhibin B and estradiol obtained shortly after Gn stimulation indicate the need for a longer period of Gn treatment and a higher daily dosage; (3) No obvious pregnancy difference among patients of age <35 years was found; however, IVF pregnancy outcome is significantly lower in women of age >35 years.

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Section: Introductionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 93%

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Dynamic measurements of serum inhibin B and estradiol: apredictive evaluation of ovarian response to gonadotrophin stimulation in the early stage of IVF treatment

Miao

Huang

2009

J. Zhejiang Univ. Sci. B

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“…The mean age of women (29.2 years) was close to that reported in Egyptian (29.0 years), Iranian (29.1 years) and Palestinian (28.7 years) studies, 13,15,16 but lower than that reported from the USA and South Korea (34.0 years). 17,18 The younger women seeking IVF in developing countries, including Gaza Strip, could be explained in the context of social habits where most families have the desire to have children immediately after marriage and they encourage women to undergo IVF. This is supported by the finding that around half of the study population had undergone repeated IVF.…”

Section: Discussionmentioning

confidence: 99%

Impact of Age on Ovarian Response and IVF Outcome during Controlled Ovarian Hyperstimulation in Women from Gaza Strip

et al. 2014

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“…According to a recent report, E 2 levels obtained early after initiation of ovarian stimulation directly reflect follicular activity and ovarian responsiveness to exogenous gonadotropins (14). Use of serum E 2 levels obtained shortly after the initiation of gonadotropin stimulation could provide an early marker of ovarian responsiveness, and might in case of predicting a high ovarian response assist in deciding whether to cancel the cycle or to adapt the stimulation-dose by decreasing the amount of gonadotropins.…”

Section: Introductionmentioning

confidence: 99%

Use of Stimulated Serum Estradiol Measurements for the Prediction of Hyperresponse to Ovarian Stimulation in in Vitro Fertilization (IVF)

Hendriks

Klinkert

Bancsi

et al. 2004

J Assist Reprod Genet

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Purpose : In ovarian stimulation an exaggerated ovarian response is often seen and is related to medical complications, such as ovarian hyperstimulation syndrome (OHSS), and increased patient discomfort. If it were possible to identify hyperresponders at an early stage of the stimulation phase, adaptation of the stimulation protocol would become feasible to minimize potential complications. Therefore, we studied the usefulness of measuring stimulated serum estradiol (E 2 ) levels in predicting ovarian hyperresponse. Methods : A total of 109 patients undergoing their first IVF treatment cycle using a long protocol with GnRH agonist was prospectively included. The E 2 level was evaluated on day 3 and 5 of the stimulation phase. Two outcome measures were defined. The first was ovarian hyperresponse (collection of ≥15 oocytes at retrieval and/or peak E 2 > 10000 pmol/L, or cancellation due to ≥30 follicles growing and/or peak E 2 > 15000 pmol/L, or OHSS developed). The second outcome measure comprised a subgroup representing the more severe hyperresponders, named extreme-response (cancellation or OHSS developed). Results : The data of 108 patients were analyzed. The predictive accuracy of E 2 measured on stimulation day 3 towards ovarian hyperresponse was clearly lower than that of E 2 measured on stimulation day 5 (area under the receiver operating characteristic curve (ROC AUC ) 0.75 and 0.81, respectively). For extreme-response the predictive accuracy of E 2 measured on stimulation day 3 or 5 was comparable (ROC AUC 0.81 and 0.82, respectively). For both outcome measures the stimulated E 2 tests yielded only acceptable specificity with moderate sensitivity at higher cutoff levels. Prediction of extreme-response seemed slightly more effective due to a lower error rate. Conclusions : There is a significant predictive association between E 2 levels measured on stimulation day 3 and 5 and both ovarian hyperresponse and extreme-response in IVF. However, the clinical value of stimulated E 2 levels for the prediction of hyperresponse is low because of the modest sensitivity and the high false positive rate. For the prediction of extreme-response the clinical value of stimulated E 2 levels is moderate.

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Day 4 Estradiol Levels Predict Pregnancy Success in Women Undergoing Controlled Ovarian Hyperstimulation for IVF

Cited by 44 publications

References 17 publications

Dynamic measurements of serum inhibin B and estradiol: apredictive evaluation of ovarian response to gonadotrophin stimulation in the early stage of IVF treatment

Dynamic measurements of serum inhibin B and estradiol: apredictive evaluation of ovarian response to gonadotrophin stimulation in the early stage of IVF treatment

Impact of Age on Ovarian Response and IVF Outcome during Controlled Ovarian Hyperstimulation in Women from Gaza Strip

Use of Stimulated Serum Estradiol Measurements for the Prediction of Hyperresponse to Ovarian Stimulation in in Vitro Fertilization (IVF)

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