Search Results
Search for other papers by Nardin Aslih in
Google Scholar
PubMed
Search for other papers by Mediea Michaeli in
Google Scholar
PubMed
Search for other papers by Diana Mashenko in
Google Scholar
PubMed
Search for other papers by Adrian Ellenbogen in
Google Scholar
PubMed
Search for other papers by Oshrit Lebovitz in
Google Scholar
PubMed
Search for other papers by Yuval Atzmon in
Google Scholar
PubMed
Search for other papers by Einat Shalom-Paz in
Google Scholar
PubMed
Aim
To find a cut-off ratio of estradiol/metaphase II oocyte (E2/M2) ratio and to evaluate the correlation with patients’ characteristics, embryo morphokinetics using EmbryoScope™ and IVF cycle outcomes.
Material and methods
For this retrospective cohort study, records of all fresh cycles that were cultured and scored by EmbryoScope™ were evaluated. The peak E2/M2 ratio was calculated on the day of human chorionic gonadotropin (hCG) administration and correlated to embryo morphokinetic quality and cycle outcomes. A receiver operating characteristics analysis was calculated for the E2/M2 ratio and clinical pregnancy rates.
Results
A total of 2461 oocytes were collected from 319 patients. Receiver operating characteristics analysis revealed a cutoff of 204 as a discriminative point to predict clinical pregnancy with a sensitivity of 69.5% and specificity of 62.1% (P < 0.001). E2/M2 > 204 group were older, had higher E2 concentration, fewer M2 oocytes despite elevated gonadotrophin doses. E2/M2 ratio ≤ 204 was correlated with higher fertilization rate, better embryo quality, higher pregnancy and live birth rates, and more frozen embryos.
Conclusion
E2/M2 ratio < 204 yielded the best probability to achieve good quality embryos with good morphokinetic scores and better pregnancy outcomes and may be used to predict IVF cycle outcomes. Advanced maternal age and low ovarian response received higher concentrations of gonadotrophins, which resulted in higher E2/M2 ratio. Milder stimulation to those patients may improve their cycle outcomes.
Search for other papers by Yasmin Shibli Abu Raya in
Google Scholar
PubMed
Search for other papers by Asaf Bilgory in
Google Scholar
PubMed
Search for other papers by Nardin Aslih in
Google Scholar
PubMed
Search for other papers by Yuval Atzmon in
Google Scholar
PubMed
Search for other papers by Maya Shavit in
Google Scholar
PubMed
Search for other papers by Daniela Estrada in
Google Scholar
PubMed
Search for other papers by Moamina Sharqawi in
Google Scholar
PubMed
Ruth and Bruce Rappaport School of Medicine, The Technion Institute of Technology, Haifa, Israel
Search for other papers by Einat Shalom-Paz in
Google Scholar
PubMed
This study evaluated β-human chorionic gonadotropin (hCG) changes during the early period of pregnancy in an attempt to predict successful pregnancy outcomes in ART. It determined the median values of the β-hCG and the 2-day β-hCG increments of clinical vs biochemical pregnancies. The results of fresh day 3 embryo, frozen day 3 embryo, and frozen day 5 embryo transfers were evaluated. The cutoff values of β-hCG and the 2-day increments predicting clinical pregnancy and delivery were determined. All women who underwent embryo transfer and had a singleton pregnancy from January 2017 to December 2019 were included. As expected, clinical pregnancies had higher initial median β-hCG values compared to biochemical pregnancies (fresh day 3 (400 vs 73 mIU/mL), frozen day 3 (600 vs 268.5 mIU/mL) and frozen day 5 (937 vs 317 mIU/mL)). Nonetheless, the abortion rate was significantly lower in the group with β-hCG above the cutoff values in fresh (141 mIU/mL) and frozen (354.5 mIU/mL) cleavage stage transfers (17.2% vs 44%, P < 0.001 and 18.5% vs 38%, P = 0.003, respectively). Blastocyst transfers resulted in higher median initial β-hCG compared to cleavage embryo transfers (937 vs 600 mIU/mL), and the initial β-hCG values from frozen cleavage embryos were higher compared to fresh cleavage embryos (600 vs 400 mIU/mL). Earlier implantation in frozen cycles may be caused by freezing–thawing procedures. Moreover, in fresh cycles, negative effects of the hormonal milieu of fresh cycles may delay implantation. These results indicate that high initial β-hCG and high 2-day β-hCG increments demonstrated better outcomes, including more clinical pregnancies and fewer abortions.
