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- Title
Estradiol Level on Day 9 as a Predictor of Risk for Ovarian Hyperresponse During Controlled Ovarian Hyperstimulation.
- Authors
Hsin-Yi Ho; Kuo-Kuang Lee, Robert; Ming-Huei Lin; Yuh-Ming Hwu
- Abstract
Purpose: To investigate the estradiol (E[sub 2]) level in the mid-follicular phase during controlled ovarian hyperstimulation (COH) and evaluate it as a predictor of a high risk for ovarian hyperresponse. Methods: From January 1996 to October 2001, the records of a total of 146 patients undergoing 164 COH cycles were retrospectively reviewed. All patients received the long protocol of GnRH agonists from the previous mid-luteal phase and then hMG or FSH from day 3 of the menstrual cycle. The E[sub 2] level was evaluated on day 9. Ovarian hyperresponse was defined as 1) an E[sub 2] level on the day of hCG injection was >4000 pg/mL, or 2) the necessity for coasting during COH to decrease the risk of ovarian hyperstimulation syndrome (OHSS). Results: Of the 52 cycles in which day 9 E[sub 2] level was >800 pg/mL, 29 (55.8%) fulfilled the criteria for ovarian hyperresponse. None of patients whose day 9 E[sub 2] level was <300 pg/mL met the criteria for hyperresponse. The pregnancy rate in the groups with day 9 E[sub 2] level <300 pg/mL was 42.9%; for an E[sub 2] level = 300-800 pg/mL, 49.2%; and for an E[sub 2] level > 800 pg/mL, 32.7%. The corresponding implantation rates were 18.8, 28.0, and 17.0%. The E[sub 2] level on day 9 did not correlate with clinical pregnancy rates or implantation rates. Conclusions: A high E[sub 2] level in the mid-follicular phase was predictive of patients with a high ovarian response. An E[sub 2] level on day 9 of menstrual cycle of >800 pg/mL suggests an increased risk for ovarian hyperresponse, and appropriate management should be instituted to decrease the risk of OHSS.
- Subjects
ESTRADIOL; OVARIES; REPRODUCTIVE technology
- Publication
Journal of Assisted Reproduction & Genetics, 2003, Vol 20, Issue 6, p222
- ISSN
1058-0468
- Publication type
Article
- DOI
10.1023/A:1024155411444