ESTRADIOL AS PROGNOSTIC MARKER OF OVARIAN HYPERSTIMULATION SYNDROME IN ASSISTED REPRODUCTIVE TECHNOLOGIES

Objective. To study the serum estradiol concentrations correlation with ovarian hyperstimulation syndrome (OHSS) in women undergoing assisted reproductive technologies (ART) and to assess the estradiol role as a prognostic marker of OHSS in ART.

Materials and methods. We carried out complex clinical and laboratory examinations of 718 women that underwent the in vitro fertilization program (IVF) at the Center of Reproductive Medicine (Minsk, Belarus) in 2014-2017. We divided the cohort into two groups depending on the controlled ovarian stimulation protocol. We measured the estradiol serum levels three times during the IVF-programs: on the day of the final oocyte maturation trigger injection; on the day of the planned embryo transfer (ET); on the 5th day after the ET or its cancellation.

Results. The serum estradiol concentrations were significantly higher (p<0.05) in the Group 1 patients i.e. in cases of the controlled ovarian stimulation with GnRH-agonists. We found a statistically significant correlation between the estradiol levels and the ovarian hyperstimulation syndrome manifestations: the ROC-curves were characterized by AUC > 0.9; high sensitivity and specificity (> 80%). The cut-off levels of the serum estradiol values were established. They are the following: on the day of the final oocyte maturation trigger injection — 1895 pg/ml, on the day of the planned ET — 1108 pg/ml, on the 5th day after ET or its cancellation — 890 pg/ml.

Conclusion. Serum estradiol levels can be used as a reliable prognostic marker of OHSS in ART when exceeding the established cut-off levels.

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Автор(ы): S. V. Zhukovskaya, L. F. Mozheyko