Oxidative stress indices in follicular fluid as measured by the thermochemiluminescence assay correlate with outcome parameters in in vitro fertilization.
OBJECTIVE
To evaluate oxidative stress indices in follicular fluid (FF) by a novel thermochemiluminescence (TCL) assay and investigate the correlation between TCL and i.v.f. cycle parameters.


METHODS
Prospective, cross-sectional study.


METHODS
I.v.f. Unit of an Obstetrics and Gynecology Department in a university-affiliated hospital.


METHODS
One hundred eighty-nine women undergoing consecutive i.v.f. treatment cycles during 2001.


METHODS
After oocyte retrieval, pooled FF was centrifuged and the supernatant was tested in the TCL assay.


METHODS
Maximal serum E2 levels, number of gonadotropin ampoules, retrieved oocytes, mature oocytes, fertilization and cleavage rates, number of available embryos and cryopreserved embryos, and clinical pregnancy rates and correlation with TCL indices.


RESULTS
The TCL curve slope of FF positively correlated with maximal serum E2 levels, number of mature oocytes, and number of cleaved embryos and was inversely correlated with the women's ages and the number of gonadotropin ampoules. Follicular fluid TCL amplitude at 50 seconds ranged from 294 to 711 cps, but all pregnancies (n = 50; 28.1%) occurred within the range of 347-569 cps. With 385 and 569 cps as cutoff levels for the occurrence of pregnancy, the negative predictive value beyond this range was 96% and the positive predictive value within this range was 32%.


CONCLUSIONS
The TCL results may reflect the age-related increase in free radical activity and is associated with parameters of ovarian responsiveness and IVF outcome. A certain threshold of oxidative stress may be required for the occurrence of conception in i.v.f. TCL is a potential tool to evaluate, treat, and monitor antioxidant therapy in i.v.f. treatments.
IVF Unit, Department of Obstetrics and Gynecology, Carmel Medical Center, Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
Zofnat
Z
Wiener-Megnazi
Liad
L
Vardi
Arie
A
Lissak
Sergei
S
Shnizer
Abraham Zeev
AZ
Reznick
David
D
Ishai
Shirly
S
Lahav-Baratz
Hanna
H
Shiloh
Mara
M
Koifman
Martha
M
Dirnfeld
D000328:Adult; D000375:Aging; D003430:Cross-Sectional Studies; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000378:metabolism*; D006358:Hot Temperature; D006801:Humans; D008163:Luminescent Measurements; D018384:Oxidative Stress; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies