EFFECT OF FINAL SERUM ESTRADIOL AND PROGESTERONE LEVEL ON THE OUTCOME OF INTRACYTOPLASMIC SPERM INJECTION

Document Type : Preliminary preprint short reports of original research

Authors

1 Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University

2 Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Egypt.

3 Faculty of Medicine, Department of Obstetrics and Gynecology, Alexandria University

Abstract

Introduction and Aim of the Study
Infertility affects about 10–15% of couples globally. Assisted reproductive techniques like ICSI are vital tools for treatment. This study focused on the impact of final serum estradiol (E2) and progesterone (P4) levels on the day of hCG trigger, as well as the P4/E2 ratio, on ICSI outcomes. The aim was to assess how these hormonal parameters correlate with oocyte maturity, embryo quality, and pregnancy rates.
Patients and Methods
This prospective study included 410 infertile women aged 20–38 years undergoing ICSI at Alexandria IVF centers. Participants underwent a standardized GnRH antagonist stimulation protocol. On the hCG trigger day, serum E2 and P4 levels were measured. Outcomes included number of oocytes retrieved, MII oocyte ratio, fertilization rate, good-quality embryo ratio, and clinical pregnancy. Data were analyzed using statistical correlation and regression techniques.
Results and Conclusions
The average MII oocyte ratio was 80%, fertilization rate 76%, and good-quality embryo ratio 65%. Clinical pregnancy occurred in 45.6% of cases. Higher good-quality embryo ratios were significantly associated with pregnancy. P4 and P4/E2 showed positive correlations with embryo quality but not with pregnancy rate. The MII oocyte ratio was the strongest independent predictor of embryo quality. Excessively elevated P4 or P4/E2 may impair implantation, suggesting hormone monitoring can optimize ICSI outcomes.

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