Evaluation of basal estradiol levels in assisted reproductive technology cycles

Objective: To determine if basal E-2 screening increases the diagnostic acc uracy of basal FSH screening and to determine whether basal E-2 levels corr elate with outcome in ART cycles. Design: Retrospective. Setting: Tertiary care center. Patient(s): Two thousand six hundred thirty-four infertility patients. Intervention(s): Cycle outcome was evaluated after grouping patients by bas al E-2 levels beginning at <20 pp/mL and extending to >100 pg/mL at 10 pg/m L increments. Main Outcome Measure(s): Retrieved oocytes, pregnancy rate, and cancellatio n rate. Result(s): Cancellation rates were significantly increased in patients with basal E-2 levels of <20 pg/mL or greater than or equal to 80 pg/mL. Basal E-2 levels neither predicted pregnancy outcome nor correlated with ovarian response in those patients not canceled. Conclusion(s): Patients with basal E-2 levels of <20 pg/mL or greater than or equal to 80 pg/mL had an increased risk for cancellation. Basal E-2 was predictive of stimulation parameters in patients 40 years or older. For tho se patients who proceeded to retrieval, there were no differences in pregna ncy or delivery rates relative to basal E-2 levels. This suggests that irre spective of basal E-2 levels patients who produce mure than three maturing follicles in response to stimulation have adequate ovarian reserve as evide nced by their pregnancy rates. (Fertil Steril(R) 2000:74:518-24. (C) 2000 b y American Society for Reproductive Medicine.).