Background: The outcome of in vitro fertilization (IVF) is influenced by a number of factors. One of the most important factors is oocyte quality. The microenvironment of the follicular fluid is important for oocyte development. 
Objectives: Assessment of the accuracy of follicular fluid estradiol level in predicting clinical pregnancy outcome, oocyte quality and fertilization rate in women undergoing ICSI.
Methodology: The current study was prospective study that included 180 women. Follicular fluid concentrations of 17β-estradiol were determined using the enzyme immunosorbent assays. Upon retrieval, oocytes were analyzed for hallmarks of maturity and classified as GV, MI, or MII based on appearance. Fertilization status observed at 24 h and the nutrient solution renewed, morphology of the dividing embryo was observed and ‘embryo grading' done.
Results: 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 was of 36.1) and 103 of cases had embryo transfer on day 5 ,77 had transfer on day 3.
Conclusion: Follicular fluid E2 concentration had fair predictive value in oocyte maturation, fertilization, embryo quality, chemical and clinical pregnancy. But it was an independent predictor of MII-grade oocytes production.