Evaluation of serum estradiol/ progestrone ratio on day of embryo transfer and it's effect on intra cytoplasmic sperm induction outcome

One of the important problems in fertilization in vitro (IVF) is failure of
implantation. This could be the result of estrogen and progesterone effects in
endometrial acceptance during ovulation stimulation. Although progesterone has a vital
role in primary phase of pregnancy, but the estradiol role in luteal phase is unknown.
The aim of this study is assessment of the ratio of estradiol to progesterone in embryo
transfer day on Intracytoplasmic sperm injection (ICSI) outcomes.
Methods: This is a cohort study. The subjects were 311 infertile women referred to
Urmia Kosar infertility clinic & Urmia reproductive health research center who treated
with ICSI method between August-Jan 2011. Five cc blood was drawn for determine of
estradiol and progesterone in transfer day. Transfer occurred after a variable in vitro
culture period ranging from 48 to 72 hours after ovulation induction. Chemiluminescent
ELICA the level of mention hormones was used to determine the ratio of the
progesterone level to the estradiol serum level and was compared based on treatment
outcomes.
Results: A total of 311 patients, 115 (37%) were pregnant and happened abortion were 18
(5.8%). The mean ratio of estradiol to progesterone in transfer day in two groups of
miscarriage/ non miscarriage and pregnant/ non pregnant was 32.26±23.86, 28.17±26.5
and 28.58±2.4, 36.09±4.39 respectively. There is no significant difference between two
groups in regard of estradiol on progesterone ratio (P=0.5, P= 0.2).
Conclusion: The results of this prospective cohort study show that there is no effect of
estradiol to progesterone ratio on day of embryo transfer, successful pregnancy in ICSI
cycles and abortion rate following of ICSI