Follicular fluid progesterone concentration is associated with fertilization outcome after IVF: a systematic review and meta-analysis

Nagy, Bernadett; Pótó, László; Farkas, Nelli; Koppán, Miklós; Várnagy, Ákos; Kovács, Kálmán; Papp, S; Bohonyi, Noémi; Bódis, József

doi:10.1016/j.rbmo.2018.12.045

Cited by 22 publications

(24 citation statements)

References 46 publications

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“…We found that progestin levels are higher in FF from those oocytes resulting in correct fertilization, in agreement with a recent meta-analysis 16 . In particular, we have shown that FF P levels can identify oocytes undergoing correct fertilization with fair accuracy and an OR of 4.2 in women stimulated with the FSH protocol.…”

Section: Discussionsupporting

confidence: 92%

“…Overall, our results further corroborate the role of progestins in promoting oocyte maturity as well as fertilization competence 13,16,41,42 . Conversely, a role in fertilization competence of other steroid hormones did not emerge from our study.…”

Section: Discussionsupporting

confidence: 84%

“…Several studies evaluated FF steroid levels in relation to oocyte maturity 13 or ART outcomes 4 , 5 , 14 – 16 , but results are conflicting. The controversy may depend on the fact that some of these studies utilized pooled FF 5 , 17 , others considered only the individual FF retrieved from the first or the dominant follicle 14 , 15 or evaluated steroid levels only in those follicles leading to an embryo transfer 4 .…”

Section: Introductionmentioning

confidence: 99%

“…The controversy may depend on the fact that some of these studies utilized pooled FF 5,17 , others considered only the individual FF retrieved from the first or the dominant follicle 14,15 or evaluated steroid levels only in those follicles leading to an embryo transfer 4 . Although the recent meta-analysis by Nagy et al 16 reported a positive association between progesterone FF levels and fertilization rate, the Authors concluded that the results should be interpreted with caution, because the included studies are very heterogeneous regarding couple inclusion/exclusion criteria, women stimulation protocols, and methods of evaluation of the steroids. The method used to evaluate steroids is important.…”

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confidence: 99%

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LH supplementation of ovarian stimulation protocols influences follicular fluid steroid composition contributing to the improvement of ovarian response in poor responder women

Marchiani

Benini

Pallecchi

et al. 2020

Sci Rep

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In this prospective study, we evaluated the steroid levels in 111 follicular fluids (FF) collected from 13 women stimulated with FSH monotherapy and 205 FF collected from 28 women stimulated with FSH + LH because of a previous history of hypo-responsiveness to FSH. Steroid levels were measured by HPLC/MS-MS and related to ovarian stimulation protocol, oocyte maturity, fertilization and quality of blastocysts, after individually tracking the fate of all retrieved oocytes. 17-Hydroxy-Progesterone, Androstenedione, Estradiol and Estrone were significantly higher in the FSH + LH protocol. Progesterone, 17-Hydroxy-Progesterone and Estradiol were more expressed in FF yielding a mature oocyte (p < 0.01) in the FSH + LH protocol. FF Progesterone concentration was correlated with the rate of normal fertilization in the FSH protocol. None of the FF steroids measured were associated with blastocyst quality and achievement of pregnancy. Our results indicate that LH supplementation in hypo-responsive women modifies ovarian steroid production, mimicking physiological production better and likely contributing to an improved ovarian response. Employing a correct methodological procedure to evaluate the relationship between FF steroid hormones and assisted reproduction outcomes, our study reveals that some steroids in single follicles may be helpful in predicting oocyte maturity and fertilization. Infertility is a global problem estimated to affect about 80 million couples in the world. Infertile couples may rely on assisted reproduction techniques (ARTs) which include IVF (in vitro fertilization) and ICSI (intracytoplasmic sperm injection) to achieve a pregnancy. These treatments not only aim at solving fertility problems but also offer a great opportunity to study human reproductive physiology more in depth, presenting the chance to benefit from biological fluids otherwise impossible to obtain. For instance, human follicular fluid (FF) samples provide a crucial microenvironment involved in oocyte development. Their composition depends largely on secretions of granulosa and thecal cells and is influenced by hormonal, paracrine and autocrine signals 1. In ARTs, all mature retrieved oocytes are usually fertilized but only a part of them develops into an embryo which results in a successful implantation. Clarifying which factors in FF regulate the development and acquisition of oocyte competence is a major goal of current research.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

LH supplementation of ovarian stimulation protocols influences follicular fluid steroid composition contributing to the improvement of ovarian response in poor responder women

Marchiani

Benini

Pallecchi

et al. 2020

Sci Rep

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show abstract

“…As the immediate and necessary microenvironment of oocytes, follicular fluid (FF) provides nutrients and growth factors that promote oocyte growth, development, and viability by accumulating products from all types of metabolism [4,5]. A study found that changes in the constituents of the FF, such as phthalate, might affect the steroidogenic capacity or viability of follicular cells, and thereby alter the levels of ovarian hormones [6].…”

Section: Introductionmentioning

confidence: 99%

Human follicular fluid shows diverse metabolic profiles at different follicle developmental stages

Yang

Feng

et al. 2020

Reprod Biol Endocrinol

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Background: To investigate the metabolic profiles in the follicular fluid (FF) samples from patients undergoing in vitro fertilization (IVF) and to analyze the correlations with follicular development. Methods: The FF samples were obtained from participants (N = 26) who were receiving IVF under the gonadotropin-releasing hormone agonist (GnRH-a) long protocol stimulation and were collected separately from small (8-13 mm) and large (17-22 mm) follicles at the time of oocyte retrieval. Metabolomic analysis of the FF samples was performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Results: The results demonstrated that the size of the follicle influences the metabolic signature of the FF according to the profile and differential metabolites. Dehydroepiandrosterone (DHEA), which is enriched in steroid hormone biosynthesis, correlated negatively with the oocyte maturation rate and the high-quality embryo rate, and thus could be used to estimate the predictive diagnostic potential of follicular development. Conclusion: The FF has different metabolic characteristics in different stages of follicular development. Exploring meaningful metabolites could predict follicular development, and modifications of these metabolites could influence follicular development.

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Follicular microenvironment: Oxidative stress and adiponectin correlated with steroids hormones in women undergoing in vitro fertilization

Luti

Fiaschi

Magherini

et al. 2020

Molecular Reproduction Devel

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Research has been focused on determining the follicular microenviroment produced by the theca and granulosa cells since the molecular characterisation of this body fluid could lead to the understanding of several fertility problems. Oxidative stress may be one of the factors involved in female infertility since it plays a key role in the modulation of oocyte maturation and finally pregnancy. An increase in oxidative stress is correlated with inflammation and intense research was developed to understand the interaction between inflammation and adiponectin, based on the fact that many adipokines are inflammation related proteins linked to reactive oxygen species production. The aim of this study is to investigate the correlation between total adiponectin levels and oxidative stress amount in the serum and follicular fluid (FF) of women who undergone in vitro fertilization. Moreover we verified the expression of adiponectin in granulosa and cumulus cells. To clarify the predictive value of steroid hormones in human assisted reproduction, twelve steroid hormones in FF and serum, were quantified in a single run liquid chromatography/mass spectrometry, by using a multiple reaction monitoring mode and we related the serum and follicular fluids adiponectin levels with the concentration of the investigated steroid hormones.

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Follicular fluid progesterone concentration is associated with fertilization outcome after IVF: a systematic review and meta-analysis

Cited by 22 publications

References 46 publications

LH supplementation of ovarian stimulation protocols influences follicular fluid steroid composition contributing to the improvement of ovarian response in poor responder women

LH supplementation of ovarian stimulation protocols influences follicular fluid steroid composition contributing to the improvement of ovarian response in poor responder women

Human follicular fluid shows diverse metabolic profiles at different follicle developmental stages

Follicular microenvironment: Oxidative stress and adiponectin correlated with steroids hormones in women undergoing in vitro fertilization

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