Dual Impact of Estradiol Fluctuations in the Final Three Days on IVF/ICSI Outcomes: A Retrospective Cohort Analysis

Dynamic E2/P monitoring provides actionable insights for COS management. Elevated E2 in the late stimulation phase, driven by AFC and mid-cycle hormonal surge, correlates with oocyte yield but requires caution due to reduced embryo utilization. Clinically, excessive gonadotropin dosing and prolonged stimulation should be avoided to optimize outcomes. These findings support personalized hormone adjustment protocols to balance efficacy and safety in ART cycles.