Evaluation of the relationship between serum estradiol levels on human chorionic gonadotropin administration day and intracytoplasmic sperm injection outcomes: A retrospective population-based study

Hajshafiha M, Masoumeh Hajshafiha, Sima Oshnouei, Oshnouei S, Mostafavi M, Mahdieh Mostafavi, Dindarian S, Sina Dindarian, Kiarang N, Nazila Kiarang, Mohammadi S
International journal of reproductive biomedicine · 2021 · vol. 19(7) , pp. 599–606 · doi:10.18502/ijrm.v19i7.9470 · PMID:34458668 · PMC8387705
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This retrospective study analyzed 551 ICSI cycles and found that serum estradiol levels on hCG administration day significantly correlated with oocyte yield, embryo number, pregnancy, and abortion rates in women aged 37-42.

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This retrospective population-based study analyzed 551 women undergoing intracytoplasmic sperm injection to evaluate how serum estradiol levels on the human chorionic gonadotropin administration day correlate with treatment outcomes. The researchers found that higher estradiol concentrations were significantly associated with increased numbers of retrieved oocytes and embryos in both younger and older patient groups, although pregnancy rates varied by age and estradiol level. Notably, while younger women showed higher pregnancy rates with elevated estradiol, older women achieved better results with lower levels, and the study explicitly excluded participants with a history of endometriosis. Relevance to endometriosis: The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

BACKGROUND: The correlation between high estradiol (E2) levels induced by controlled ovarian hyperstimulation (COH) and pregnancy is controversial. OBJECTIVE: To assess the effect of serum E2 levels on the day of human chorionic gonadotropin administration on the intracytoplasmic sperm injection (ICSI) outcome. MATERIALS AND METHODS: The current study included 551 participants who had undergone ICSI between May 2014 and May 2016. Based on E2 levels, the individuals aged < 37 yr (n = 502) and 37-42 yr (n = 49) were categorized into six and three groups, respectively. ICSI outcomes including the number of retrieved oocytes (NRO), number of embryos (NE), pregnancy rate, and abortion rate were analyzed in both groups. RESULTS: Among participants aged < 37 yr, the NRO and NE were 8.69 ± 3.82 and 5.24 ± 2.32, respectively and they had a significant correlation with the E2 level on human chorionic gonadotropin administration day (p 37 yr, NRO and NE were 5.18 ± 3.17 and 3.40 ± 2.23, respectively, and the NRO (p < 0.001), NE (p < 0.001), pregnancy rate (p < 0.001), abortion rate (p = 0.007), and the number of grade A and B embryos (p = 0.003) had a significant association with the E2 level. CONCLUSION: COH is a costly procedure that may have negative effects on endometrial receptivity. Thus, in order to prevent these effects and also to reduce the costs of COH, we recommend gaining optimum number of oocytes rather than maximum number during the procedure.
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In conclusion, our findings suggest that an increased level of E2 does increases the NRO but it has no effect on number of transferred embryos and PR. High levels of E2 may have negative effects on endometrial receptivity. Thus, for preventing the adverse effects of COH on endometrial receptivity and also in order to decrease the costs of the procedure, gaining optimum number of oocytes should be the aim of COH rather than gaining maximum number.

Coi Statement

The authors declare no conflict of interest.

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