title: Cortisol and cortisone in human follicular fluid and serum and the outcome of IVF treatment.
abstract: BACKGROUND
  The glucocorticoid status of ovarian follicular fluid has been linked to oocyte quality. The aim of this study was to examine whether the concentrations of cortisone and cortisol and their calculated ratios in the follicular fluid and serum samples are predictive of IVF outcome.
  
  
  METHODS
  In the prospective study of 387 patients (420 treatment cycles) undergoing IVF treatment the concentrations of cortisone and cortisol were measured with specific assays, and their calculated ratios in the follicular fluid and serum samples obtained after ovarian stimulation and induced ovulation were determined.
  
  
  RESULTS
  In 75 patients, treatment resulted in clinical pregnancy and was associated with significantly lower follicular cortisone (24+/-12 versus 29+/-16 nmol/l, P<0.002) and higher cortisol/cortisone ratio (7.24+/-2.22 versus 6.45+/-2.17 nmol/l, P<0.007). In addition, the ratios of serum cortisone and cortisol to follicular cortisone and cortisol were significantly higher in those women who became pregnant.
  
  
  CONCLUSIONS
  We propose that the follicular fluid glucocorticoid concentration resulting from the conditions in the circulation and the course of the intrafollicular cortisol-cortisone interconversion appear to play a role in the outcome of IVF.
authors.affiliation: Departments of Pharmacology and Gynecology, University of Heidelberg, 69120 Heidelberg, Germany. sabina.lewicka@urz.uni-heidelberg.de
authors.forename: Sabina
authors.initials: S
authors.lastname: Lewicka
authors.forename: Cornelia
authors.initials: C
authors.lastname: von Hagens
authors.forename: Ute
authors.initials: U
authors.lastname: Hettinger
authors.forename: Klaus
authors.initials: K
authors.lastname: Grunwald
authors.forename: Paul
authors.initials: P
authors.lastname: Vecsei
authors.forename: Benno
authors.initials: B
authors.lastname: Runnebaum
authors.forename: Thomas
authors.initials: T
authors.lastname: Rabe
mesh_terms: D000328:Adult; D003348:Cortisone / Q000097:blood / Q000378:metabolism*; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000378:metabolism*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism*; D007247:Infertility, Female / Q000097:blood / Q000378:metabolism / Q000628:therapy; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies
chemical_list: D003348:Cortisone; D006854:Hydrocortisone