EStradiol and PRogesterone in In vitro ferTilization (ESPRIT): a multicenter study evaluating third- versus second-generation estradiol and progesterone immunoassays

J Endocrinol Invest. 2020 Sep;43(9):1239-1248. doi: 10.1007/s40618-020-01211-x. Epub 2020 Mar 13.

Abstract

Purpose: To assess estradiol (E2) and progesterone levels during ovarian stimulation determined by third-generation (Gen III) and second-generation (Gen II) Elecsys® immunoassays.

Methods: E2 and progesterone concentrations were measured using Elecsys® Gen III and Gen II immunoassays, and progesterone concentrations on the day of ovulation triggering were determined by LC-MS/MS. This was a retrospective, non-interventional study conducted at European tertiary referral infertility clinics in women aged 18-45 years, with a body mass index 18-35 kg/m2, regular menses, and both ovaries.

Results: Serum samples were obtained from 230 women classified by oocyte retrieval as poor (33.0%; 0-3 oocytes), normal (40.9%; 4-15 oocytes), or high (26.1%; > 15 oocytes) responders. E2 and progesterone levels increased during ovarian stimulation, with greatest increases observed in high responders. Elecsys® Gen III and Gen II assay results were highly correlated for E2 (Pearson's r = 0.99) and progesterone (r = 0.89); Gen III results were lower than Gen II for both E2 and progesterone. On the day of triggering, Gen III E2 and progesterone levels showed a difference of - 15.0% and - 27.9%, respectively. Progesterone levels (on day of triggering) measured by LC-MS/MS correlated better with Gen III (0.98) than Gen II (0.90). Mean relative differences for Gen III and Gen II assays versus LC-MS/MS were 14.6% and 62.8%, respectively.

Conclusion: E2 and progesterone levels determined with Elecsys® Gen II and III assays were highly correlated; results were lower for Gen III versus Gen II. Differences observed for progesterone on the day of triggering may be clinically relevant.

Keywords: Estradiol; Immunoassay; In vitro fertilization; Ovarian stimulation; Progesterone.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Blood Chemical Analysis / methods*
  • Chromatography, Liquid
  • Estradiol / analysis
  • Estradiol / blood*
  • Female
  • Fertilization in Vitro*
  • Humans
  • Immunoassay / methods
  • Middle Aged
  • Monitoring, Physiologic / methods
  • Ovulation Induction*
  • Progesterone / analysis
  • Progesterone / blood*
  • Retrospective Studies
  • Tandem Mass Spectrometry
  • Young Adult

Substances

  • Progesterone
  • Estradiol