Objective: To evaluate the impact of elevated peak estradiol (E(2)) levels and a high number of retrieved oocytes on implantation and pregnancy rate in patients undergoing in vitro fertilization-embryo transfer (IVF-ET) and intracytoplasmic sperm injection (ICSI).
Methods: Retrospectively analyzed 474 infertile women undergoing 510 cycles for IVF-ET/ICSI treatment during the period of March 1999 to December 2000. Using a standard long protocol/flare-up protocol [(gonadotropic hormone releasing hormone agonist/high pure follicle-stimulating hormone (FSH-HP)/human chorionic gonadotropin (hCG)] for ovarian stimulation. High responders were defined as those who had peak E(2) levels of > 11 010 pmol/L on the day of hCG administration (n = 160) or > 15 retrieved oocytes (n = 148). Normal responders were defined as those who had peak E(2) levels of </= 11 010 pmol/L on the day of hCG administration (n = 350) or </= 15 retrieved oocytes (n = 362).
Results: There were statistically significant differences in age, infertile years, basal FSH level and the ampules of FSH-HP required between high and normal responders (P < 0.01 and P < 0.05). Ovarian hyperstimulation syndrome (OHSS) increased significantly in the high responders (P < 0.01). There were no statistically significant differences in implantation rate or pregnancy rate between high and normal responders.
Conclusion: Elevated peak E(2) levels and high oocytes retrieved were not detrimental to IVF outcome, but had high incidence of OHSS.