The predictive value and the management of cycles with low initial estradiol levels

A. Hershlag, M. C. Asis, M. P. Diamond, A. H. DeCherney, G. Lavy

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

This study was undertaken to examine the predictive value of low estradiol (E2) after 5 days of human menopausal gonadotropin (hMG) stimulation response to therapy in that cycle. We further examined whether the outcome of such cycles can be improved by increasing the hMG dose. When 18 cycles in which day 8 E2 was ≤ 50 pg/mL were compared with 48 cycles with corresponding E2 levels of 51 to 150 pg/mL, the former showed a significantly worse response to subsequent hMG therapy. To determine the effect of an increase in hMG dose we studied 48 cycles with day 8 E2 of 51 to 150 pg/mL. In 32 cycles hMG dose was increased from three to a mean of five ampules a day, after 5 days of therapy. In 16 cycles it was kept constant at three ampules per day. Although a tendency towards lower fertilization rate was observed in the higher hMG group, no significant differences were observed in the results between the two groups. We thus conclude that very low E2 levels after 5 days of gonadotropin therapy are predictive of low response in that cycle, and that in cycles with day 8 E2 of 51 to 150 pg/mL, increasing the dosage of hMG on day 8 and beyond does not alter the course of the cycle.

Original languageEnglish (US)
Pages (from-to)1064-1067
Number of pages4
JournalFertility and sterility
Volume53
Issue number6
DOIs
StatePublished - 1990
Externally publishedYes

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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