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Abstract Infertility is the third most serious disease worldwide estimated by the WHO (Santos, 2014). Despite the worldwide use of ICSI, it still has a low birth rate (∼30%). In order to maximize its success, exogenous gonadotropins are used for ovarian stimulation to generate multiple follicles. However these gonadotropins have been shown to have deleterious effects on oocyte and embryo quality. Exposure of the oocyte to supra-physiological concentrations of gonadotropins has been demonstrated to disturb oocyte maturation and the completion of meiosis leading to chromosomal aneuploid oocytes (Santos, 2013). Moreover, in practice, increasing the oocytes number retrieved is correlated with lower oocyte quality since not all oocytes result in healthy embryos (Lamb et al., 2010). This is due to poor oocyte developmental competence, which is now referred as “oocyte quality”, which has no real parameter till now. It is now widely accepted that oocyte quality affects embryo quality, through the fact that most of embryo cytoplasm is derived from the oocyte and this contributes to early embryogenesis and embryonic genome activation (Gilbert et al., 2015). Summary & Conclusion 124 Follicular fluid (FF) provides a very important microenvironment for the development of oocyte and contains various factors that mediate the growth of follicles and oocytes (Ducolomb et al., 2013). In addition, E2 enhances the cytoplasmic maturation of oocytes via direct non-genomic action at the plasma membrane level, in turn inducing extracellular calcium influx into the cell and a specific pattern of Ca2+ oscillations (Anifandis et al., 2005). Elevated E2 in FF indicate a more advanced stage of oocyte maturation and have been repeatedly found to be associated with a higher chance of achieving pregnancy. The role of estradiol in in vitro fertilization (IVF) is well known up to the fertilization stage (Devroey et al., 2004). The current study was prospective study that included 180 women underwent Intra-cytoplasmic sperm injection (ICSI) procedure. Using Flexible Antagonist protocol. During oocyte retrieval, follicular fluids of mature follicles (>17 mm) aspirated. Follicular fluid concentrations of 17β-estradiol was determined using the enzyme immunosorbent assay kits (Immunospec Corporation, Canoga Park, USA). Summary & Conclusion 125 Upon retrieval, oocytes were analyzed for hallmarks of maturity and classified as GV, MI, or MII based on appearance (Muasher et al., 2006). Fertilization status observed at 24 h and the nutrient solution renewed, morphology of the dividing embryo was observed and „embryo grading‟ done (Gardner et al., 2004). At least in the two-cell stage embryo transfer were be done at second to third day after the oocyte collection. Only patients with freshly transferred embryos included. Quantitative S.B HCG measured at 14 days post transfer, followed by a vaginal ultrasound 2 weeks later demonstrating an embryonic cardiac pulse. The number of retrieved oocytes ranged from (1 to 33 oocytes) mean number 10±7. Follicular fluid E2 concentration ranged from 246±199 (0 to 700) (ng\ ml). Serum E2 concentration ranged from 2361±1583 (100 to 7589) pg\ml. The mean of total number oocytes was 10 with 53% of MII of good quality. And (47%) were of bad quality. All cases had normal fertilization. Number of transferred Embryos ranged from one to three embryos (good quality was of 63.9%), (bad quality Summary & Conclusion 126 was of 36.1) and 103 of cases had embryo transfer on day 5 ,77 had transfer on day 3. Chemical pregnancy was positive in 90 cases (50%) and the clinical pregnancy positive in 66 cases (36.7%). In follicular fluid E2 concentration ranged from 220 to 476 ng\ml that they had clinical pregnancy and ranges from 36 to 320 ng\ml had no clinical pregnancy. |