Objective To evaluate role of serum estradiol levels in predicting likelihood of pregnancy in women undergoing GnRH-a protocol in IVF-ET cycles. Design A 3-year retrospective analysis of estradiol levels on down-regulated day 2, day 6, and day of hCG trigger and subsequent clinical pregnancy rates. Setting A university hospital tertiary referral centre. Population or Sample Women undergoing IVF treatment. Methods Hormonal assessment on the down-regulated day 2, day 6, and day of hCG trigger. Main Outcome Measure(s) Comparison of hormonal profile, antral follicular count on day 2, endometrial thickness on day of trigger, and number of oocytes retrieved between pregnant and the non-pregnant group. The prediction of IVF success was based on the quantitative levels of estradiol on a specific day in down-regulated cycle. Result(s) The overall pregnancy rate was 32.25 % (50/ 160). Estradiol level on down-regulated day 2 was 31.9 ± 12.6 and on the day of trigger was 1,996.46 ± 1,252.36 in pregnant women, which was significantly higher as compared to estradiol levels in nonpregnant women (27.6 ± 12.3 and 1,525