OBJECTIVES

Although, earlier studies have evaluated the significance of various estradiol patterns during controlled ovarian hyperstimulation (COH), their prognostic significance remains unclear. The objective of this study is to investigate the rate of increase in estradiol (ROI-E2) during COH and evaluate it as a predictor of ovarian response.

METHODS

In this retrospective study, 130 patients undergoing COH for IVF/ICSI cycles were reviewed. The E2 level during COH was evaluated on day 1,5,6,7 & 8 and the ROI-E2 was determined. Age, basal FSH, number of mature follicles, number and maturity of oocytes, and incidence of ovarian hyperstimulation syndrome (OHSS) were recorded and their relationship with ROI-E2 was determined.

RESULTS

Patients with elevated basal FSH have shown poor ROI-E2 on day six and a significant negative correlation was observed. Similarly, patients with advanced age group demonstrated poor ROI-E2 on day six. The average ROI-E2 on day six was significantly higher in patients who developed OHSS than non-OHSS group. The number of follicles, oocytes and maturity of the oocytes were maximum among the patients with higher ROI-E2 on day six.

CONCLUSION

In a COH cycle, there is significant predictive association between ROI-E2 on day six and good ovarian response and hyper response.

Keywords: ovarian response, rate of increase of serum estradiol, artifical reproductive techniques