Comprehensive Assessment of Serum Estradiol Impact on Selected Physiologic Markers Observed During In-Vitro Fertilization and Embryo Transfer Cycles

Abstract

Objective: This investigation assessed the effect of serum estradiol levels on the outcomes of in-vitro fertilization and embryo transfer (IVF-ET) cycles. Methods: This was a retrospective cohort study on 1123 IVF-ET cycles comparing impact of estradiol (E2) levels on follicular development, fertilization, embryo quality, implantation, pregnancy rate, miscarriage rate, and selected obstetric outcomes. Results: We found high serum E2 levels to be significantly associated with increased number of mature follicles and mature oocytes retrieved (p< 0.01, for both). E2 levels were also associated with more viable and good-quality embryos (p< 0.01). There was no significant impact of E2 levels on oocyte maturation, fertilization rate, embryo quality, or overall pregnancy rates. Moreover, high E2 levels were significantly associated with higher implantation rates and reduced incidence of miscarriage (p< 0.05, for both). Conclusion: Within the safety range in clinical practice, our data demonstrate a positive effect of high serum E2 on selected IVF parameters.