The Effect of Serum Estradiol Level at the Time of HCG Injection on the ICSE Outcome
Keywords:IVF-ICSI, Ovarian hyperstimulation syndrome, E2.
Background: In addition to multi-follicular development, controlled stimulation of ovaries is associated
with a high serum level of estradiol (E2). The increased serum E2 level during COS may therefore be
associated either with an increased chance of pregnancy or an impaired reproductive outcome secondary to
changed endometrial receptivity.
Objective: To assess the effect of serum estradiol level at the day of hCG administration on the success of
intracytoplasmic sperm injection (ICSI) cycles
Patients and Method: A retrospective study, in which a total of 235 women who were undergo a single
ICSI cycle were introduced in this retrospective study, All patients were received gonadotrophin agonist
either short or long protocol. The patients were classified at the day of hCG administration into three groups
according to serum E2 level group A <1000pg/ml, group B 1000-3000pg/ml and group C >3000pg/ml.
Results: The mean number of retrieved oocytes and embryos obtained in group C were more than in group
A and B but clinical pregnancy rate was higher in group B than in group A and group C which is statistically
Conclusion: Although there is no high quality evidence to support a positive correlation between serum E2
levels and IVF-ICSI products, the E2 level in the serum may has a level –dependent effect on the success
of pregnancy. The optimal range of serum E2 is 1000-3000pg/ml is associated with higher rate of clinical
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