Value of estradiol response after human chorionic gonadotropin administration in predicting in vitro fertilization success

Objective: To determine whether the serum E-2 response after the administra tion of exogenous hCG is predictive of outcome during IVF. Design: Prospective, noncomparative cohort. Setting: Two academic centers and one private-practice IVF program. Patient(s): Two hundred twenty-two couples undergoing IVF for infertility a rising from ovarian dysfunction, asthenoteratospermia, endometriosis, tubal disease, or unexplained infertility. Main Outcome Measure(s): implantation, pregnancy, and miscarriage rates wer e compared in cycles that demonstrated an increase, decrease, or plateau in the serum E-2 level on the day after hCG administration. The effects of ag e, cause of infertility, and maximum E2 value on outcome were evaluated. Result(s): Ninety-two cycles resulted in a clinical pregnancy and 130 cycle s failed. Of 115 cycles in which the E-2 level rose, 42 (37%) resulted in a n ongoing pregnancy; among cycles with plateauing E-2 responses, 20 of 69 ( 29%) resulted in a pregnancy. Fifteen of 38 (39%) of cycles exhibiting a dr op in serum E-2 resulted in an ongoing pregnancy. No statistically signific ant differences in ongoing pregnancy rates were noted in the increasing, pl ateauing, or decreasing E-2 response groups. Conclusion(s): E-2 values obtained on the day after hCG administration are not predictive of outcome in women undergoing IVF. (Fertil Steril(R) 1999;7 2:542-5. (C) 1999 by American Society for Reproductive Medicine.).