Controlled Ovarian Hyperstimulation: Usefulness of Estradiol and Progesterone monitoring
Abstract
Due to their major roles in female reproduction, estradiol and progesterone are commonly monitored during assisted reproductive technology (ART) protocols including in vitro fertilization (IVF) and artificial insemination (AI). Estradiol, by reflecting follicle growth, helps to detect high or poor responders and adjust drug doses accordingly, prevents the risk of ovarian hyperstimulation syndrome (OHSS) and has a predictive value on pregnancy outcome. Progesterone is an interesting biomarker used during controlled ovarian hyperstimulation (COH). By reflecting luteal phase progress, its monitoring provides an important information on the implantation window. High progesterone level on the day of ovulation triggering is associated with a reduced chance of embryo implantation. Consequently, its monitoring provides an important information that can lead to embryo freezing for a transfer on a next cycle. Moreover, there is a growing body of literature showing that freeze-all policy seems to improve the cost-effectiveness of both the protocols and IVF outcomes, while reducing the risk of OHSS. In this context, progesterone monitoring has become a key factor during controlled ovarian hyperstimulation protocols. In order to summarize the role of estradiol or progesterone monitoring, alone or associated with transvaginal ultrasonography (TVUS) results, we have investigated its importance in the management of patients under COH in four French ART centers.
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DOI: http://dx.doi.org/10.18103/imr.v3i12.605
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