Dr. Rehana Rehman, PhD, Assistant Professor, Department of Biological & Biomedical Sciences, Aga Khan University, Karachi - Pakistan.
Dr. Shireen Jawed, M.Phil, Assistant Professor of Physiology, Islam Medical & Dental College, Sialkot, Pakistan.
Pak J Med Sci. 2014 Sep;30(5):986-91. doi: 10.12669/pjms.305.5175.
To observe effect of peak estradiol (E2) levels on outcome after intra cytoplasmic sperm injection (ICSI).
Quasi experimental design conducted in "Islamabad Clinic Serving Infertile Couples" from June 2010 till August 2011. Down regulation with mid luteal suppression of 564 females aged 18-41 years was done with gonadotrophin releasing hormone agonist followed by controlled ovarian stimulation, ovulation induction (OI), oocytes pickup and embryo transfer. Samples for peak serum E2 at the time of OI was estimated by Enzyme Linked Immuno Sorbent Assay. The association of peak E2 with outcome groups of Intracytoplasmic sperm injection (ICSI) (Group I) beta hCG <5 m IU/ml, (Group II) with beta hCG>5 mI U/ml and no cardiac activity and (Group III) with beta hCG>5mIU/ml and cardiac activity on trans vaginal scan was identified. Statistical comparison by one way analysis of variance (ANOVA) via SPSS version 15 was done.
A clinical pregnancy rate of 36% was achieved, pregnant females(Group III) had higher peak E2 2269 ± 80.97 as compared to 1419 ± 37.07 and 1807±90.28 pg/ml (mean ± SD) in Groups I and II respectively (p<0.0001) Elevated serum E2 was significantly associated with better oocyte recovery, fertilization, cleavage and implantation rates (p<0.0001) .
A high serum E2 measured on OI day can predict success of treatment after ICSI. Females who had high peak E2 had greater number of retrieved, mature and fertilized oocytes with thick endometrial lining that helped in implantation and clinical pregnancy.
观察卵胞浆内单精子注射（ICSI）后峰雌二醇（E2）水平对结局的影响。
2010 年 6 月至 2011 年 8 月在“伊斯兰堡不孕夫妇诊所”进行准实验设计。对 564 名年龄在 18-41 岁的女性进行黄体中期下调抑制，并用促性腺激素释放激素激动剂进行控制性卵巢刺激、排卵诱导（OI）、卵母细胞采集和胚胎移植。通过酶联免疫吸附试验（ELISA）估计 OI 时血清 E2 峰的样本。将峰 E2 与 ICSI（I 组）β hCG <5 mIU/ml、（II 组）β hCG>5 mIU/ml 且无心脏活动和（III 组）β hCG>5 mIU/ml 且经阴道超声扫描有心脏活动的结果组相关联。通过 SPSS 版本 15 的单因素方差分析（ANOVA）进行统计学比较。
获得了 36%的临床妊娠率，怀孕女性（III 组）的峰 E2 更高，为 2269 ± 80.97 pg/ml，而 I 组和 II 组分别为 1419 ± 37.07 和 1807±90.28 pg/ml（均值 ± SD）（p<0.0001）。血清 E2 升高与更好的卵母细胞回收、受精、卵裂和着床率显著相关（p<0.0001）。
OI 日测量的高血清 E2 可预测 ICSI 后的治疗成功。E2 峰值高的女性有更多的可回收、成熟和受精的卵母细胞，以及较厚的子宫内膜，这有助于着床和临床妊娠。
