Can serum estradiol levels on the fourth day of IVF/ICSI cycle predict outcome in poor responder women?

Abstract

We aimed to investigate the value of fourth day serum estradiol levels in predicting cycle outcome in poor responders. The medical records of 426 patients with low oocyte yield following controlled ovarian hyperstimulation (COH) treatment for a procedure in our institution’s center for ART between 2008 and 2013 were evaluated. Eighty-eight patients exhibiting poor ovarian response (POR) were included in the study. The clinical outcomes of IVF/ICSI were compared based on the basal hormone profile, clinical, and laboratory parameters. Cycle day 4 E2 levels below 110 pg/ml had an odds ratio of 6.05 (95% CI 2.33–15.7; p < 0.001) for embryo transfer. The early follicular response to ovarian stimulation can be anticipated with the cycle day 4 estradiol levels during COH. When a low day 4 serum estradiol level is encountered, abandoning the current COH and proceeding with agents that increase ovarian response to ovarian stimulation before the next treatment cycle can be a realistic approach.

• Assisted reproductive technology
• estradiol
• infertility
• poor responder

Declaration of interest

The authors report no declarations of interest. There remain no relevant potential conflicts of interest related to this original article. Also, there remains no affiliation with any organization with a financial interest, direct or indirect in the subject matter or materials discussed in the manuscript. The authors did not receive any funding and/or financial support from any commercial or other association for this study.

Author contributions

All authors contributed significantly to this study, all authors are in agreement with the content of the manuscript and approved the final version of the paper. All authors participated in all works needed for preparing the final original research. Concept, design, and all comments of this original research are prepared and established by all of the authors as active participants. Conceived and designed the study: YE-U, NY; Collected the data: SK, OHY, SY, IK; Analyzed the data: SK, ASO-E; Wrote the manuscript: SK, OHY, ASO-E.