TY - JOUR
T1 - Impact of peak estradiol levels on reproductive outcome of intracytoplasmic sperm injection
AU - Rehman, Rehana
AU - Jawaid, Shireen
AU - Gul, Hina
AU - Khan, Rakhshaan
PY - 2014
Y1 - 2014
N2 - Objective: To observe effect of peak estradiol (E2) levels on outcome after intra cytoplasmic sperm injection (ICSI). Methods: Quasi experimental design conducted in "Islamabad Clinic Serving Infertile Couples" from June 2010 till August 2011. Down regulation with mid luteal suppression of 564 females aged 18-41 years was done with gonadotrophin releasing hormone agonist followed by controlled ovarian stimulation, ovulation induction (OI), oocytes pickup and embryo transfer. Samples for peak serum E2 at the time of OI was estimated by Enzyme Linked Immuno Sorbent Assay. The association of peak E2 with outcome groups of Intracytoplasmic sperm injection (ICSI) (Group I) beta hCG <5 m IU/ml, (Group II) with beta hCG>5 mI U/ml and no cardiac activity and (Group III) with beta hCG>5mIU/ml and cardiac activity on trans vaginal scan was identified. Statistical comparison by one way analysis of variance (ANOVA) via SPSS version 15 was done. Results: A clinical pregnancy rate of 36% was achieved, pregnant females(Group III) had higher peak E2 2269 ± 80.97 as compared to 1419 ± 37.07 and 1807±90.28 pg/ml (mean ± SD) in Groups I and II respectively (p < 0.0001) Elevated serum E2 was significantly associated with better oocyte recovery, fertilization, cleavage and implantation rates (p < 0.0001). Conclusion: A high serum E2 measured on OI day can predict success of treatment after ICSI. Females who had high peak E2 had greater number of retrieved, mature and fertilized oocytes with thick endometrial lining that helped in implantation and clinical pregnancy.
AB - Objective: To observe effect of peak estradiol (E2) levels on outcome after intra cytoplasmic sperm injection (ICSI). Methods: Quasi experimental design conducted in "Islamabad Clinic Serving Infertile Couples" from June 2010 till August 2011. Down regulation with mid luteal suppression of 564 females aged 18-41 years was done with gonadotrophin releasing hormone agonist followed by controlled ovarian stimulation, ovulation induction (OI), oocytes pickup and embryo transfer. Samples for peak serum E2 at the time of OI was estimated by Enzyme Linked Immuno Sorbent Assay. The association of peak E2 with outcome groups of Intracytoplasmic sperm injection (ICSI) (Group I) beta hCG <5 m IU/ml, (Group II) with beta hCG>5 mI U/ml and no cardiac activity and (Group III) with beta hCG>5mIU/ml and cardiac activity on trans vaginal scan was identified. Statistical comparison by one way analysis of variance (ANOVA) via SPSS version 15 was done. Results: A clinical pregnancy rate of 36% was achieved, pregnant females(Group III) had higher peak E2 2269 ± 80.97 as compared to 1419 ± 37.07 and 1807±90.28 pg/ml (mean ± SD) in Groups I and II respectively (p < 0.0001) Elevated serum E2 was significantly associated with better oocyte recovery, fertilization, cleavage and implantation rates (p < 0.0001). Conclusion: A high serum E2 measured on OI day can predict success of treatment after ICSI. Females who had high peak E2 had greater number of retrieved, mature and fertilized oocytes with thick endometrial lining that helped in implantation and clinical pregnancy.
KW - Controlled ovarian stimulation
KW - Intracytoplasmic sperm injection
KW - Peak Estradiol
UR - http://www.scopus.com/inward/record.url?scp=84904689828&partnerID=8YFLogxK
U2 - 10.12669/pjms.305.5175
DO - 10.12669/pjms.305.5175
M3 - Article
AN - SCOPUS:84904689828
SN - 1682-024X
VL - 30
JO - Pakistan Journal of Medical Sciences
JF - Pakistan Journal of Medical Sciences
IS - 5
ER -