Evaluation of the relationship between serum estradiol levels on human chorionic gonadotropin administration day and intracytoplasmic sperm injection outcomes: A retrospective population-based study

Background: The correlation between high estradiol (E۲) levels induced by controlled ovarian hyperstimulation (COH) and pregnancy is controversial. Objective: To assess the effect of serum E۲ levels on the day of human chorionic gonadotropin administration on the intracytoplasmic sperm injection (ICSI) outcome. Materials and Methods: The study included ۵۵۱ participants who had undergone ICSI between May ۲۰۱۴ and May ۲۰۱۶. Based on E۲ levels, the individuals aged < ۳۷ yr (n = ۵۰۲) and aged ۳۷-۴۲ yr (n = ۴۹) were categorized into six and three groups, respectively. ICSI outcomes including the number of retrieved oocytes (NRO), number of embryos (NE), pregnancy rate, and abortion rate were analyzed in both groups. Results: Among participants below ۳۷ yr, the NRO and NE were ۸.۶۹ ± ۳.۸۲ and ۵.۲۴ ± ۲.۳۲, respectively and they had a significant correlation with the E۲ level on human chorionic gonadotropin administration day (p < ۰.۰۰۱ for both). Among participants above ۳۷ yr, NRO and NE were ۵.۱۸ ± ۳.۱۷, ۳.۴۰ ± ۲.۲۳, respectively and the NRO (p < ۰.۰۰۱), NE (p < ۰.۰۰۱), pregnancy rate (p < ۰.۰۰۱), abortion rate (p = ۰.۰۰۷) and the number of grade A and B embryos (p = ۰.۰۰۳) had a significant association with the E۲ level. Conclusion: COH is a costly procedure that may have negative effects on endometrial receptivity. Thus, in order to prevent these effects and also to reduce the costs of COH, we recommend gaining optimum number of oocytes rather than maximum number during the procedure.  

Keywords:

Intracytoplasmic sperm injection , In vitro fertilization , Estradiol , Pregnancy. , تزریق داخل سیتوپلاسمی اسپرم , لقاح خارج رحمی , استرادیول , حاملگی.