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Korean Journal of Reproductive Medicine 2007;34(3):197-205.
Published online September 1, 2007.
Pregnancy and Implantation Rates Related to Serum Estradiol Concentrations of Controlled Ovarian Hyperstimulation in Fresh IVF-ET and Frozen-thawed ET Cycles.
Myo Kyung Kim, Su Jin Choi, Hye Won Choi, Kyoung Hee Bang, Hye Ok Kim, Kwang Moon Yang, Mi Kyoung Koong, Jong Young Jun, Jin Hyun Jun
1Laboratory of Reproductive Biology and Infertility, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
2Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
This study evaluated the pregnancy and implantation rates in fresh IVF-ET cycles or frozen-thawed ET (F-ET) cycles based on serum estradiol concentrations of controlled ovarian hyperstimulation (COH). METHODS: Clinical outcomes of 1,565 cycles of fresh IVF-ET with COH and 670 cycles of F-ET were retrospectively analyzed. Serum estradiol levels on the day of human chorionic gonadotropin (hCG) administration were categorized into Group-A (1,000~ 2,000 pg/ml), Group-B (2,000~3,000 pg/ml), Group-C (3,000~4,000 pg/ml) and Group-D (> 4,000 pg/ml). Clinical pregnancy (CPR), implantation (IR) and delivery rates (DR) were compared among four groups subdivided into younger (< 35 years) and older (> or = 35 years) women. Statistical analysis was performed by Student's t-test and chi-square test. RESULTS: Overall clinical outcomes with fresh IVF-ET and F-ET cycles were similar: 41.2% vs 44.8% of CPR, 18.8% vs 19.6% of IR, and 33.2% vs 34.5% of DR, respectively. There were no significant differences in the clinical outcomes of all four groups between fresh IVF-ET and F-ET cycles of younger women according to the estradiol levels. However, the clinical outcomes of F-ET cycles of older women in Group-D were significantly higher than those of fresh IVF-ET cycles (51.3% vs 25.0% of CPR*, 18.6% vs 9.9% of IR and 33.3% vs 19.4% of DR; *p<0.05). CONCLUSION: Our results demonstrated that supraphysiological levels of estradiol during COH in fresh IVF-ET cycles of older women (> or = 35 years) may be detrimental to implantation environments of endometrium and clinical outcomes, which could be improved by F-ET cycles.
Key Words: Estradiol concentration; Controlled ovarian hyperstimulation; Frozen-thawed ET; Implantation environments; Clinical outcomes
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