Human chorionic gonadotrophin and steroid concentrations in follicular fluid: the relationship to oocyte maturity and fertilization rates in stimulated and natural in-vitro fertilization cycles

Abstract

The study investigates the relationship of follicular fluid steroids and human chorionic gonadotrophin to oocyte maturity and fertilization rates in stimulated and natural cycles. Oestradiol, progesterone, testosterone and human chorionic gonadotrophin were quantified in 129 samples of follicular fluid and the progesterone:oestradiol ratio calculated. Both stimulated cycles (short and long luteinizing hormone-releasing hormone/human menopausal gonadotrophin regimens) and natural cycles were compared. A total of 60 women were studied, 20 in each group. In the natural cycles, testosterone was significantly lower in follicles with intermediate oocytes (P = 0.015). Both oestradiol and testosterone were significantly lower in stimulated cycles compared to natural cycles (P = 0.032 and P = 0.034 respectively). In the ovarian stimulation cycles, the progesterone:oestradiol ratio was significantly higher when oocytes fertilized (P = 0.052). Moreover, in the stimulated cycles, oestradiol and human chorionic gonadotrophin were singnificantly lower in the short protocol compared to the long protocol. The data demonstrate that the hormonal milieu of the follicle is altered in down-regulated stimulated cycles to varying degrees, depending partially on the type of protocol used. Furthermore, the progesterone:oestradiol ratio, rather than individual hormone concentrations, may be a useful predictor of the fertilizing capacity of the oocytes.

The levels of steroid hormones and cytokines in individual follicles are not associated with the fertilization outcome after intracytoplasmic sperm injection

“…Uehara et al (29) and Hartshorne et al (30) did not find any relationship, while Enien et al reported higher P/E 2 ratios in follicles yielding successfully fertilized oocytes (31).…”

The clinical role of interleukin-6 and interleukin-6 soluble receptor in human follicular fluids

“…It has been suggested that estradiol-17β and progesterone might be markers of the level of oocyte maturity and fertilization [22,23]. However, some previous studies found no correlation between oocyte maturity and the concentrations of estradiol-17β and progesterone in FF [24,25]. Consequently, there is no agreement concerning the relationship between ovarian steroid hormones and oocyte maturation.…”

Non-canonical progesterone signaling in granulosa cell function

“…R5020’s ability to stimulate P4 secretion is observed at concentrations equal to or greater than 16 μM. While 16 μM may appear to be a pharmacological dose, it is within the physiological range, since women undergoing either natural or gonadotropin-stimulated cycles have P4 follicular fluid levels between 15 to 60 μM (Enien, et al 1995, Kamel, et al 1994, Tarlatzis, et al 1993). However, human PGRMC1 binds R5020 with high affinity (EC 50 of ≈ 10 nM; Figure 2A; (Peluso, et al 2009).…”