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Pre-ovulatory plasma levels of 17beta-oestradiol (E2) and conception in patients treated with gonadotrophins.

Twenty-six patients seeking advice for sterility were given courses of treatment with HMG-HCG. Ovarian maturation was followed by daily evaluation of plasma 17beta-oestradiol concentrations. HCG was administered as soon as 17beta-oestradiol levels reached 250 pg/ml. In a first group of 7 amenorrheic patients with lack of oestrogen activity, a pregnancy rate of 71.4% and an ovulation rate of 91.7% were achieved. In a second group of 5 amenorrheic patients showing evidence of oestrogen activity, a pregnancy rate of 80.0% and an ovulation rate of 100% were obtained. In a third group of 14 oligomenorrheic patients, the pregnancy rate attained 71.4% and the ovulation rate 96.9%. The overall pregnancy rate was 73.0%. With this procedure of monitoring HMG-HCG treatment by means of plasma 17beta-oestradiol levels, the multiple pregnancy rate reached only 11.7% and only one case of mild ovarian hyperstimulation was observed. Pre-ovulatory and pre-conceptional 17beta-oestradiol concentration were identical with those observed in spontaneous ovulatory cycles with or without conception.