Evaluation of the relationship between follicular fluid oxidative stress, ovarian hormones, and response to gonadotropin stimulation.
OBJECTIVE
To investigate the relationship between oxidative stress and the underlying causes of infertility, preovulatory ovarian hormones, and ovarian response to gonadotropin stimulation in patients undergoing assisted reproductive techniques.


METHODS
Prospective, cross-sectional study.


METHODS
Assisted conception unit, university hospital.


METHODS
One hundred thirty women presenting with infertility, of the following types: male factor (n = 56), unexplained (n = 36), tubal factor (n = 16), polycystic ovary syndrome (n = 15), and endometriosis (n = 7).


METHODS
Follicular fluid (FF) and peripheral blood samples were collected at oocyte retrieval.


METHODS
Blood and FF samples were analyzed for inhibin A, inhibin B, activin A, anti-Müllerian hormone, and E(2) by using ELISA. Total antioxidant capacity (TAC) was measured in plasma and FF by using a calorimetric microplate assay.


RESULTS
There was no significant relationship between plasma or FF TAC and the underlying etiology of infertility. There was a statistically significant positive association between FF E(2) levels and TAC (r = 0.26). Higher antral follicle count, delta E(2) (day 3 E(2) minus day 2 E(2)), preovulatory serum anti-Müllerian hormone, inhibin B, and E(2) were associated with good ovarian response, whereas higher FF E(2) was associated with a statistically significant poor response. No significant direct relationship was observed between TAC and ovarian response as well as between TAC or any of the parameters measured and pregnancy outcome.


CONCLUSIONS
Oxidative stress has an impact on the production of granulosa cell steroid hormones, in particular E(2), which is an important predictor of ovarian response. The positive association between FF E(2) and total antioxidant capacity suggests that E(2) may play a role in the ovarian antioxidant-oxidant balance.
Academic Department of Obstetrics and Gynaecology, Royal Free and University College London, University College London Campus, London, United Kingdom. apmala01@yahoo.co.uk
Malathy
M
Appasamy
Eric
E
Jauniaux
Paul
P
Serhal
Ahmed
A
Al-Qahtani
Nigel P
NP
Groome
Shanthi
S
Muttukrishna
D028341:Activins / Q000378:metabolism; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000378:metabolism; D000975:Antioxidants / Q000378:metabolism; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000378:metabolism; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000378:metabolism*; D042341:Gonadal Hormones / Q000097:blood / Q000378:metabolism*; D006062:Gonadotropins / Q000008:administration & dosage*; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D007265:Inhibins / Q000378:metabolism; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction / Q000379:methods*; D018384:Oxidative Stress; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D016896:Treatment Outcome
D000975:Antioxidants; D005300:Fertility Agents, Female; D042341:Gonadal Hormones; D006062:Gonadotropins; C422405:activin A; C422362:inhibin A; C422364:inhibin B; D028341:Activins; D004958:Estradiol; D007265:Inhibins; D054304:Anti-Mullerian Hormone