Serum estradiol concentrations as a predictor of successful outcome in artificial frozen-thawed embryo transfer cycles
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20221922Keywords:
Estradiol, FET, ICSI, PregnancyAbstract
Background: The role of late follicular serum estradiol monitoring in artificial FET cycles remain unclear. The purpose of this study was to evaluate the correlation between serum estradiol levels on the day of starting progesterone supplementation with clinical pregnancy rates in FET cycle.
Methods: This was a non-interventional observational cohort study of patients undergoing ICSI followed by FET at Nadkarni hospital and test tube baby center, Killa-Pardi, Gujarat during the period of January 2021 to May 2021. Total 64 cycles were studied and serum estradiol levels were analyzed on the day of starting progesterone supplementation. They were divided into 3 groups based on serum E2 levels (0-25th centile, 25th-75th centile and >75th centile). Chi square/Fisher exact test were used to compare the clinical pregnancy and implantation rates between these groups.
Results: Clinical pregnancy and implantation rates in group A, B and C were 68.8%, 78.1%, 75% and 36.98±9.06, 32.03±4.48 and 29.69±5.69 respectively.
Conclusions: Serum estradiol levels before progesterone supplementation in FET cycles do not predict the outcome of FET cycle therefore making routine monitoring of serum estradiol in FET cycle of questionable value.
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References
Groenewoud ER, Cantineau AE, Kollen BJ, Macklon NS, Cohlen BJ. What is the optimal means of preparing the endometrium in frozen–thawed embryo transfer cycles? A systematic review and meta-analysis. Human Reprod Update. 2013;19(5):458-70.
Boynukalin FK, Turgut NE, Gultomruk M, Ecemis S, Yarkiner Z, Findikli N, et al. Impact of elective frozen vs. fresh embryo transfer strategies on cumulative live birth: Do deleterious effects still exist in normal & hyper responders?. PloS one. 2020;15(6):e0234481.
Shapiro BS, Daneshmand ST, Garner FC, Aguirre M, Hudson C, Thomas S. Evidence of impaired endometrial receptivity after ovarian stimulation for in vitro fertilization: a prospective randomized trial comparing fresh and frozen–thawed embryo transfer in normal responders. Fertil Steril. 2011;96(2):344-8.
Paulson RJ. Hormonal induction of endometrial receptivity. Fertility and sterility. 2011;96(3):530-5.
Ghobara T, Gelbaya TA, Aveleke RO. Cycle regimens for frozen thawed embryo transfer. Cochrane Database System Rev. 2017;7:23-7.
Borini A, Dal Prato L, Bianchi L, Violini F, Cattoli M, Flamigni C. Clinical assisted reproduction: effect of duration of estradiol replacement on the outcome of oocyte donation. J Assist Reprod Genet. 2001; 18(4):187-92.
Mackens S, Santos-Ribeiro S, Van De Vijver A, Racca A, Van Landuyt L, Tournaye H, Blockeel C. Frozen embryo transfer: a review on the optimal endometrial preparation and timing. Human Reprod. 2017;32(11):2234-42.
Bu Z, Zhao F, Wang K, Guo Y, Su Y, Zhai J, Sun Y. Serum progesterone elevation adversely affects cumulative live birth rate in different ovarian responders during in vitro fertilization and embryo transfer: a large retrospective study. PloS one. 2014; 9(6):e100011.
Forman R, Belaisch-Allart J, Fries N, Hazout A, Testart J, Frydman R. Evidence for an adverse effect of elevated serum estradiol concentrations on embryo implantation. Fertil Steril. 1988;49(1):118-22.
Martel D, Monier MN, Roche D, Psychoyos A. Hormonal dependence of pinopode formation at the uterine luminal surface. Human Reprod. 1991;6(4): 597-603.
Hoff JD, Quigley ME, Yen SS. Hormonal dynamics at midcycle: a reevaluation. J Clin Endocrinol Metab. 1983;57(4):792-6.
Simon C, Cano F, Valbuena D, Remohi J, Pellicer A. Clinical evidence for a detrimental effect on uterine receptivity of high serum oestradiol concentrations in high and normal responder patients. Human Reprod. 1995;10(9):2432-7.
Ma WG, Song H, Das SK, Paria BC, Dey SK. Estrogen is a critical determinant that specifies the duration of the window of uterine receptivity for implantation. Proceed Nat Acad Sci. 2003;100(5): 2963-8.
Pellicer A, Simon C, Miro F, Castellvi RM, Ruiz A, Ruiz M, et al. Ovarian response and outcome of in-vitro fertilization in patients treated with gonadotrophin-releasing hormone analogues in different phases of the menstrual cycle. Human Reprod. 1989;4(3):285-9.
Remohi J, Ardiles G, Garcia-Velasco JA, Gaitán P, Simón C, Pellicer A. Endometrial thickness and serum oestradiol concentrations as predictors of outcome in oocyte donation. Human Reprod. 1997;12(10):2271-6.
Niu Z, Feng Y, Sun Y, Zhang A, Zhang H. Estrogen level monitoring in artificial frozen-thawed embryo transfer cycles using step-up regime without pituitary suppression: is it necessary?. J Exper Clin Assist Reprod. 2008;5(1):1-5.
Fritz R, Jindal S, Feil H, Buyuk E. Elevated serum estradiol levels in artificial autologous frozen embryo transfer cycles negatively impact ongoing pregnancy and live birth rates. J Assist Reprod Genet. 2017; 34(12):1633-8.
He W, Lv J, Lin H, Ou J, Tao X, Xing W, Cai L. Are the estrogen levels on the day of frozen-thawed embryo transfer related to the outcomes in hormonal replacement treatment cycles. Int J Clin Exp Med. 2018;11(7):7200-7.
