To determine the impact of the peak E 2 level and its midluteal decline on IVF-ET outcome in a group of normal- and high-responding patients. Retrospective analysis of IVF-ET data. Tertiary-care, university-affiliated teaching hospital. A total of 100 patients aged ≤38 years and receiving up to three embryos per transfer who underwent a similar standard controlled ovarian hyperstimulation for IVF-ET. Morning blood was collected on days 0 (hCG day), +9, and +14. Treatment cycle hormonal characteristics and percent midluteal E 2 decline in conception and nonconception cycles. Among all cycles, a mean decline of 95.0% in serum E 2 was observed at the midluteal phase. No significant differences were found in various parameters comparing conception with nonconception cycles. Occurrence of conception did not correlate with the absolute E 2 level or with percent E 2 decline in good and high responders. Early spontaneous abortion occurred more frequently in high responders with >98% E 2 decline; however, the difference did not reach statistical significance. Multifactorial analysis refutes the negative role of supraphysiologic levels of E 2 on the day of hCG administration or its dramatic decline at the midluteal phase on the success rate after embryo transfer. A possibly increased rate of early spontaneous abortion in the high-response group warrants further verification.
- Midluteal phase