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Evaluation of Fertilization State by Tracing Sperm Nuclear Morphology in Arabidopsis Double Fertilization
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Decrease in preovulatory serum estradiol is a valuable marker for predicting premature ovulation in

Xuefeng Lu1, Shuzin Khor1, Qianqian Zhu1

  • 1Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Rd, Shanghai, 200011, China.

Journal of Ovarian Research
|November 23, 2018
PubMed
Summary

Decreases in preovulatory estradiol (E2) levels effectively predict premature ovulation in natural in vitro fertilization (IVF) cycles. Utilizing emergency ovum pick-up (OPU) based on E2 decline reduces premature ovulation rates.

Keywords:
Natural IVF cyclePremature ovulationPreovulatory E2 decrease

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Area of Science:

  • Reproductive Endocrinology
  • Assisted Reproductive Technologies
  • Clinical Biochemistry

Background:

  • Premature ovulation is common in natural IVF cycles, reducing efficiency.
  • Estradiol (E2) decline in preovulatory follicles is a potential, yet unconfirmed, marker for premature ovulation.

Purpose of the Study:

  • To investigate if declining preovulatory serum estradiol (E2) levels can serve as an effective marker for predicting premature ovulation in natural IVF cycles.
  • To evaluate the impact of emergency ovum pick-up (OPU) on premature ovulation rates when guided by E2 levels.

Main Methods:

  • Retrospective analysis of 801 scheduled and 153 emergency OPU cycles in natural/unstimulated IVF/ICSI procedures.
  • Categorization of cycles based on preovulatory E2 level changes: increase (>10%), plateau (±10%), or decrease (>10%).
  • Multivariate logistic regression and ROC analysis to assess E2/-1E2 ratio as a predictive marker for premature ovulation and LH surges.

Main Results:

  • Cycles with a >10% decrease in preovulatory E2 (Group C) showed higher rates of premature LH surges and ovulation, with fewer oocytes and embryos retrieved.
  • The preovulatory E2/-1E2 ratio was significantly associated with premature ovulation and LH surges.
  • The E2/-1E2 ratio demonstrated good predictive value (AUC 0.708-0.772) for premature ovulation.
  • Emergency OPU significantly reduced premature ovulation rates and increased frozen embryo yield.

Conclusions:

  • Declining preovulatory serum E2 is a valuable marker for identifying premature ovulation risk in natural IVF cycles.
  • Emergency OPU, informed by the E2/-1E2 ratio, effectively mitigates premature ovulation in cycles with E2 decline.