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Evaluation of basal estradiol levels in assisted reproductive technology cycles
J L Frattarelli1, P A Bergh, M R Drews
1Combined Federal Program for Reproductive Endocrinology at Walter Reed Army Medical Center, National Naval Medical Center, Uniformed Services University for the Health Sciences, Bethesda, Maryland, USA. jfratt@yahoo.com
Objective:
To determine if basal E(2) screening increases the diagnostic accuracy of basal FSH screening and to determine whether basal E(2) levels correlate with outcome in ART cycles.
Design:
Retrospective.
Setting:
Tertiary care center.
Patient(S):
Two thousand six hundred thirty-four infertility patients.
Intervention(S):
Cycle outcome was evaluated after grouping patients by basal E(2) levels beginning at <20 pg/mL and extending to >100 pg/mL at 10 pg/mL increments.
Main Outcome Measure(S):
Retrieved oocytes, pregnancy rate, and cancellation rate.
Result(S):
Cancellation rates were significantly increased in patients with basal E(2) levels of <20 pg/mL or >/=80 pg/mL. Basal E(2) levels neither predicted pregnancy outcome nor correlated with ovarian response in those patients not canceled.
Conclusion(S):
Patients with basal E(2) levels of <20 pg/mL or >/=80 pg/mL had an increased risk for cancellation. Basal E(2) was predictive of stimulation parameters in patients 40 years or older. For those patients who proceeded to retrieval, there were no differences in pregnancy or delivery rates relative to basal E(2) levels. This suggests that irrespective of basal E(2) levels patients who produce more than three maturing follicles in response to stimulation have adequate ovarian reserve as evidenced by their pregnancy rates.
