The Prognostic Value of the Serum FSH and Estradiol Level in IVF Cycles Treated with GnRH Agonist

Song, J; Kim, Y H; Lee, D W; Lee, J S; Jung, E S; Kim, S H; Cho, S J; Koo, B S

Abstract

PURPOSE: To evaluate the prognostic value of serum follicular stimulating hormone (FSH) level and serum estradiol (E2) level before ovum pick up during In Vitro Fertilization-Embryo Transfer cycle. METHOD: We retrospectively analyzed the 172 cycles underwent oocyte retrieval for IVF after controlled ovarian hyperstimulation with GnRH and hMG/FSH. Serum hormone levels including FSH and LH and E2 on menstrual day 3 (Basal E2), E2 on hCG administraion day (Day 0 E2) were determined using radioimmunoassay. We also analyzed IVF-ET outcome (No. of oocytes, No. of metaphase II oocytes, No. of transferable embryos, fertilization rate, index of embryo development, pregnancy rate per cycle) related to the determined serum hormone levels.
RESULTS
1. No. of retrieved oocyte was higher in the low FSH group (<15 mIU/mL) than in the high FSH group (> or =15 mIU/mL) (9.7+/-8.3, 7.0+/-1.7; P =0.001). 2. Pregnancy rate was significantly different between two groups (13.0 %/cycle in FSH<15 mIU/mL, 0 %/cycle in FSH>15 mIU/mL; P<0.001). 3. Pregnancy rate was higher in the high responder group (E2>2000 pg/ml) than in low responder group (E2<2000 pg/ml) (25.0, 3.7 %/cycle; P<0.001). 4. Pregnancy rate was higher in high E2/Ovum group (>200 pg/ml) than in low E2/Ovum group (<200 pg/ml) (16.0, 5.3 %/cycle; P<0.001). 5. There was a positive correlation between index of embryo development and E2/Ovum(gamma=0.265; P<0.05). Conclusion; Day 3 serum FSH is the best single predictor of ovarian reserve and high serum estradiol level of the hCG administration day is an useful predictive parameter for favorable outcome of the IVF cycle treated with GnRH agonist.