Periovulatory 17β-estradiol pattern in conceptional and nonconceptional cycles during menotropin treatment of anovulatory infertility

The value of multiple parameters in the prediction of fertile cycles was prospectively evaluated in 52 menotropin-induced cycles. The periovulatory pattern of estradiol (E2) was found to correlate with conceptional cycles. E2 levels>500 pg/ml on the day of human chorionic gonadotropin administration (day 0) with a further increase on day+1 (high ascending pattern—A1) were found to have a 51% predictive value for fertile cycles. Twelve of the 17 fertile cycles had an A1 type of response (71%), whereas the overall incidence of an pattern was 42% (22 of 52). No pregnancies have occurred with preovulatory follicles≤14 mm in diameter. The number of preovulatory follicles, E2 level on day 0, and midluteal progesterone had no predictive value for fertile cycles.