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

Abstract

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.

Dynamics of early estradiol production may be associated with outcomes of in vitro fertilization

“…No significant correlations were observed between the studied dynamic variables and pregnancy outcomes. This finding was consistent with earlier reports (5)(6)(7)(8).…”

“…Some earlier studies reported that serum E 2 concentrations in the early period of ovarian stimulation may offer an early prediction of ovarian response (5). However, those studies were conducted by single or fragmentary measurement.…”

Can Inhibin B Reflect Ovarian Reserve of Healthy Reproductive Age Women Effectively?

“…The main reasons may be as follows. Firstly, Inhibin B concentrations fluctuate with the menstrual cycle and ART cycle (35,36) (Supplementary Table 3). The previous study has found that the concentration of inhibin B rose rapidly in the early follicular phase to a peak on the day after the intercycle FSH rise, then fell progressively during the remainder of the follicular phase, two days after the midcycle LH peak, there was a short-lived peak in the inhibin B concentration, which then fell to a low concentration for the remainder of the luteal phase (35).…”

Profil hormonal féminin et pronostic de la réponse à la stimulation ovarienne au cours de l’Assistance Médicale à la Procréation: Expérience du Burkina Faso

“…L'hyperoestradiolémie a été observée chez 30% des femmes et nous avons noté des différences significatives en analysant la réponse ovarienne en fonction des taux d'oestradiol à J3 du cycle. Ceci corrobore les données de Miao (2009) qui a rapporté qu'une concentration d'oestradiol > 220 pmol/L (> 60 pg/mL) est associée à une diminution du nombre d'ovocytes et quel que soit l'âge de la patiente, il n'y a pas de grossesse quand l'estradiolémie à J3 est > 275 pmol/L (> 75 ng/mL). Van der Stege (2001) a aussi rapporté une diminution du taux de grossesse de 37% à 14% lorsque l'oestradiol dépassait 80 pg/mL au troisième jour du cycle et que si ce taux dépassait 100 pg/mL, aucune grossesse n'était observée.…”