Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 4;20(3):199-205.
doi: 10.4274/tjod.galenos.2023.91043.

Does the decrease in E2 levels between the trigger of ovulation and embryo transfer affect the reproductive outcome in IVF-ICSI cycles?

Nefise Nazlı Yenigül  1 , Runa Özelci  2 , Emre Başer  3 , Serdar Dilbaz  2 , Oya Aldemir  2 , Berna Dilbaz  2 , Özlem Moraloğlu Tekin  2
Affiliations

Does the decrease in E2 levels between the trigger of ovulation and embryo transfer affect the reproductive outcome in IVF-ICSI cycles?

Nefise Nazlı Yenigül et al. Turk J Obstet Gynecol. .

Abstract

Objective: This study aimed to evaluate the effect of the rate of decline in serum estradiol (E2) levels between hCG injection and the day of embryo transfer (ET) on the success of assisted reproductive technology (ART) in women with infertility of different etiologies.

Materials and methods: Women 20-45 years of age who underwent a standard GnRH antagonist or long agonist protocol and fresh ET during day 3 of their first ART cycle were included. Group 1 was diagnosed with low ovarian reserve, group 2 comprised high ovarian responders, and group 3 consisted of normal responders. Both groups were divided into four subgroups according to the decrease in E2 levels between the day of hCG injection and the day of ET. Subgroup A patients had a decrease of <20%, subgroup B a decrease of 20-40%, subgroup C a decrease of 41-60%, and subgroup D a decrease >60%. The primary outcome measure was the effect of an E2 decline, based on the measurement of E2 on the day of hCG administration and day of ET, on the implantation rate. The secondary outcome was the change in E2 values in these three groups.

Results: The study was conducted on 1.928 women. Of these, 639 were poor responders (group 1), 502 were high responders (group 2), and 787 women had a normal ovarian response (group 3). Patients with a 60% decrease in their E2 levels on the ET day after hCG had a lower live birth rate (LBR) and higher miscarriage rate (MCR), except normoresponders, in whom a similar decline was significant only with respect to MCR.

Conclusion: We indicate that high ovarian responders who underwent fresh ET cycles with a 60% decrease in their E2 levels on the ET day after human chorionic gonadotropin had lower LBRs and higher miscarriage. However, in normoresponder women, this decline was only significant in miscarriage.

Keywords: E2 decline; high ovarian response; live birth rate; low ovarian reserve; miscarriage rate.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
Live birth and miscarriage rates in poor responders (Group 1), high ovarian responders (Group 2) and women with normal ovarian responses (Group 3) in subgroups with different E2 declines on the embryo transfer day 3
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Heger A, Sator M, Pietrowski D. Endometrial receptivity and its predictive value for IVF/ICSI-outcome. Geburtshilfe Frauenheilkd. 2012;72:710–15. - PMC - PubMed
    1. Paulson RJ. Hormonal induction of endometrial receptivity. Fertil Steril. 2011;96:530–5. - PubMed
    1. Li M, Yao L, Xin M, Gao M. Dysregulation of collagen expression in peri-implantation endometrium of women with high ovarian response. J Obstet Gynaecol Res. 2019;45:1035–44. - PubMed
    1. Fox C, Morin S, Jeong JW, Scott RT Jr, Lessey BA. Local and systemic factors and implantation: what is the evidence? Fertil Steril. 2016;105:873–84. - PMC - PubMed
    1. Ferraretti AP, La Marca A, Fauser BC, Tarlatzis B, Nargund G, Gianaroli L; ESHRE working group on Poor Ovarian Response Definition. ESHRE consensus on the definition of ‘poor response’ to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod. 2011;26:1616–24. - PubMed

LinkOut - more resources