Periovulatory Follicular Fluid Hormone Levels in Spontaneous Human Cycles*

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Abstract
We measured follicular fluid hormone levels in 48 normally cycling infertile women who underwent follicle puncture and oocyte retrieval during diagnostic laparoscopy at time-bracketed intervals after an endogenous LH surge. Follicular fluid LH, FSH, PRL, estrone (E1), estradiol (E2), progesterone (P), androstenedione (A), and testosterone (T) concentrations and P/E2 and A/E2 ratios were determined. Oocytes were classified as germinal vesicle (gv), metaphase I (ml), metaphase II (mil), or degenerating (dg). Follicular fluid (ff) hormone levels then were correlated with the stage of oocyte maturation. There were no differences in ff E1 or E2 levels at any stage of oocyte maturation, except that the mean ff E2 concentration was significantly (P < 0.05) lower in ff containing dg oocytes [2,474 ± 1,435 (±SE) nmol/L] than in those containing the other oocyte stages. The mean P levels were significantly (P < 0.0001) higher in ff containing ml (48,781 ± 10,240 nmol/L) and mil (41,801 ± 11,098 nmol/L) oocytes than in ff containing gv oocytes (1371 ± 696 nmol/L). The mean A level was highest (P < 0.01) in dg-associated ff. Similarly, T was highest (P < 0.05) in ff containing dg (52 ± 14 nmol/L) oocytes than in ff containing ml (10.7 ± 10.1 nmol/L) or mil (10.1 ± 4 nmol/L) oocytes, and it was also elevated (P < 0.05) in gv ff (72 ± 33 nmol/L) compared to mil ff. The above differences also were reflected in the P/E2 ratio, which was significantly higher (P < 0.05) in ml and mil ff, as well as in the A/E2 ratio, which was higher (P < 0.05) in ff containing ml and mil oocytes compared to ff containing gv or dg oocytes. These data define the evolving changes in the microenvironment of the follicular fluid of preovulatory follicles of normally cycling women. They also provide reference points for analysis of ff obtained from women during stimulated cycles intended for in vitro fertilization.

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