Serum estradiol level during withdrawal bleeding as a predictive factor for intermittent ovarian function in women with primary ovarian insufficiency

Kaoru Miyazaki, Fumie Miki, Sayaka Uchida, Hirotaka Masuda, Hiroshi Uchida, Tetsuo Maruyama

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Abstract

The objective of this study was to assess the potential predictive factors for follicle growth, ovulation, and pregnancy rate in patients with primary ovarian insufficiency/premature ovarian failure (POI/POF). We enrolled 25 POI patients with desired fertility who were treated and monitored for a minimum of 7 months between the years of 2000-2009 into this retrospective study. The clinical, endocrinologic, chromosomal, and autoimmunologic parameters of these patients were collected. Furthermore, hormonal backgrounds on each of 620 treatment cycles were investigated. The main outcome measures were follicle growth, ovulation, and pregnancy rate. Four of 25 patients (16%) conceived while being monitored and undergoing treatment. Follicle growth, ovulation, and pregnancy rate were not significantly different as a function of parity, iatrogenic history (e.g., chemotherapy), age of disease onset, serum estradiol (E2)/follicle stimulating hormone (FSH) level at the time of diagnosis, chromosomal abnormality, and positive autoantibody titer. The serum E2 levels on days 1-5 of withdrawal bleeding (Day 1-5 E2) were significantly higher in the cycles with successful follicle growth and ovulation than unsuccessful cycles (P < 0.05). Receiver-operator characteristic curve analysis revealed the cutoff value of the Day 1-5 E2 to be 15.5 pg/mL, and an area under the curve (AUC) value of 0.674 for follicle growth and 0.752 for ovulation. The results suggest that cycles with a Day 1-5 E2 ≥ 15.5 pg/mL have a higher rate of follicle growth and ovulation in patients with POI.

Original languageEnglish
Pages (from-to)93-99
Number of pages7
JournalEndocrine Journal
Volume62
Issue number1
Publication statusPublished - 2015

Fingerprint

Primary Ovarian Insufficiency
Ovulation
Estradiol
Hemorrhage
Pregnancy Rate
Serum
Growth
Follicle Stimulating Hormone
Parity
Age of Onset
Chromosome Aberrations
Autoantibodies
Area Under Curve
Fertility
Intercellular Signaling Peptides and Proteins
Retrospective Studies
History
Outcome Assessment (Health Care)
Drug Therapy
Therapeutics

Keywords

  • Follicle growth
  • Ovulation
  • Pregnancy
  • Premature ovarian failure
  • Primary ovarian insufficiency

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

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title = "Serum estradiol level during withdrawal bleeding as a predictive factor for intermittent ovarian function in women with primary ovarian insufficiency",
abstract = "The objective of this study was to assess the potential predictive factors for follicle growth, ovulation, and pregnancy rate in patients with primary ovarian insufficiency/premature ovarian failure (POI/POF). We enrolled 25 POI patients with desired fertility who were treated and monitored for a minimum of 7 months between the years of 2000-2009 into this retrospective study. The clinical, endocrinologic, chromosomal, and autoimmunologic parameters of these patients were collected. Furthermore, hormonal backgrounds on each of 620 treatment cycles were investigated. The main outcome measures were follicle growth, ovulation, and pregnancy rate. Four of 25 patients (16{\%}) conceived while being monitored and undergoing treatment. Follicle growth, ovulation, and pregnancy rate were not significantly different as a function of parity, iatrogenic history (e.g., chemotherapy), age of disease onset, serum estradiol (E2)/follicle stimulating hormone (FSH) level at the time of diagnosis, chromosomal abnormality, and positive autoantibody titer. The serum E2 levels on days 1-5 of withdrawal bleeding (Day 1-5 E2) were significantly higher in the cycles with successful follicle growth and ovulation than unsuccessful cycles (P < 0.05). Receiver-operator characteristic curve analysis revealed the cutoff value of the Day 1-5 E2 to be 15.5 pg/mL, and an area under the curve (AUC) value of 0.674 for follicle growth and 0.752 for ovulation. The results suggest that cycles with a Day 1-5 E2 ≥ 15.5 pg/mL have a higher rate of follicle growth and ovulation in patients with POI.",
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AU - Miyazaki, Kaoru

AU - Miki, Fumie

AU - Uchida, Sayaka

AU - Masuda, Hirotaka

AU - Uchida, Hiroshi

AU - Maruyama, Tetsuo

PY - 2015

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N2 - The objective of this study was to assess the potential predictive factors for follicle growth, ovulation, and pregnancy rate in patients with primary ovarian insufficiency/premature ovarian failure (POI/POF). We enrolled 25 POI patients with desired fertility who were treated and monitored for a minimum of 7 months between the years of 2000-2009 into this retrospective study. The clinical, endocrinologic, chromosomal, and autoimmunologic parameters of these patients were collected. Furthermore, hormonal backgrounds on each of 620 treatment cycles were investigated. The main outcome measures were follicle growth, ovulation, and pregnancy rate. Four of 25 patients (16%) conceived while being monitored and undergoing treatment. Follicle growth, ovulation, and pregnancy rate were not significantly different as a function of parity, iatrogenic history (e.g., chemotherapy), age of disease onset, serum estradiol (E2)/follicle stimulating hormone (FSH) level at the time of diagnosis, chromosomal abnormality, and positive autoantibody titer. The serum E2 levels on days 1-5 of withdrawal bleeding (Day 1-5 E2) were significantly higher in the cycles with successful follicle growth and ovulation than unsuccessful cycles (P < 0.05). Receiver-operator characteristic curve analysis revealed the cutoff value of the Day 1-5 E2 to be 15.5 pg/mL, and an area under the curve (AUC) value of 0.674 for follicle growth and 0.752 for ovulation. The results suggest that cycles with a Day 1-5 E2 ≥ 15.5 pg/mL have a higher rate of follicle growth and ovulation in patients with POI.

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