Hypothesis

Serum estradiol/progesterone ratio on day of embryo transfer may predict reproductive outcome following controlled ovarian hyperstimulation and in vitro fertilization

Irmhild Gruber , Alexander Just , Monika Birner and Alexander Lösch

Department of Gynecology and Obstetrics, IVF Outpatient Department, General Hospital of St. Poelten, Propst Führer-Strasse 4, A-3100 St. Poelten, Austria

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Journal of Experimental & Clinical Assisted Reproduction 2007, 4:1doi:10.1186/1743-1050-4-1

Published:	19 March 2007

Abstract

Background

To determine whether estradiol-to-progesterone (E₂/P) ratios at the time of embryo transfer (ET) have an effect on implantation and pregnancy in IVF cycles.

Methods

239 women consecutively treated by IVF or ICSI were retrospectively analyzed and early luteal serum E₂ and P were measured on the day of ET. Transfer occurred after a variable in vitro culture period ranging from 4-7 days after ovulation induction (OI). Following ET, serum E₂/P ratios were calculated for clinical pregnancies, preclinical abortions and non-coneption cycles.

Results

Receiver-operator curve analysis demonstrated that the E₂/P ratio could differentiate between clinical pregnancies and non-pregnant cycles (area under the curve on OI +4 days = 0.70; 95% CI = 0.60-0.80; p = 0.003, on OI +5 days = 0.76; 95% CI = 0.64-0.88; p = 0.001, OI +7 days = 0.85; 95% CI = 0.75-0.96; p < 0.0001).

Conclusion

These retrospective data may hold prognostic value regarding endometrial receptivity as reflected by E₂/P measurements and may help improve IVF treatment outcome. Further prospective studies should be undertaken to confirm these obersveration.