DAY-4 ESTRADIOL LEVELS PREDICT PREGNANCY SUCCESS IN WOMEN UNDERGOING CONTROLLED OVARIAN HYPERSTIMULATION FOR IVF

Objective: To evaluate the usefulness of serum estradiol levels obtain ed on the fourth day of, gonadotropin stimulation in predicting the li kelihood of pregnancy during controlled ovarian hyperstimulation (COH) using luteal phase leuprolide acetate (LA). Design: A 4-year retrospe ctive analysis of day 4 estradiol levels and subsequent clinical pregn ancy and delivery rates. Setting: A university hospital tertiary refer ral center. Patient(s): Couples undergoing IVF treatment. Main Outcome Measure(s): Primary outcome measures included clinical pregnancy and delivery rates. Secondary outcome measures included the number of oocy tes retrieved and the number of embryos available for transfer per COH cycle. Result(s): The clinical pregnancy and delivery rates for cycle s with day 4 estradiol levels of >75 pg/mL were 42.3% (30/71) and 32.4 % (23/71), respectively. These rates differed significantly from those for cycles with day 4 estradiol levels of less than or equal to 75 pg /mL, which were only 9.1% (4/44) and 6.8% (3/44), respectively. The nu mber of oocytes retrieved and the number of embryos available for tran sfer for cycles with day 4 estradiol levels of >75 pg/mL also differed significantly from those for cycles with day 4 estradiol levels of le ss than or equal to 75 pg/mL (11.4 and 7.8 versus 6.8 and 4.3, respect ively). Conclusion(s): Estradiol levels obtained on the fourth day of gonadotropin therapy are highly predictive of successful ovulation ind uction and pregnancy outcome in cycles using luteal phase LA. (C) 1998 by American Society for Reproductive Medicine.