Follicular fluid steroid hormone levels are associated with fertilization outcome after intracytoplasmic sperm injection.
OBJECTIVE
To investigate the association between hormone levels from individual follicles and fertilization outcome among patients undergoing intracytoplasmic sperm injection (ICSI). Differences in concentrations of selected sex steroids and pituitary hormones in individual follicular aspirates between oocytes that fertilize successfully, those that fail to fertilize, and those that degenerate with ICSI were examined.


METHODS
Prospective cohort study.


METHODS
Academic medical center.


METHODS
Women undergoing ovarian stimulation and ICSI.


METHODS
Follicular fluid was sampled by transvaginal ultrasound-guided aspiration of the hyperstimulated ovary. Each follicle was individually aspirated and collected. Intracytoplasmic sperm injection and subsequent embryo culture were performed using standard laboratory technique. Follicular fluid gonadotropin and steroid hormone levels were measured by immunoassay.


METHODS
Oocyte fertilization outcome with ICSI.


RESULTS
Oocytes that fertilized normally came from follicles with higher estradiol (adjusted odds ratio [AOR]=1.28) and testosterone (AOR=1.35) concentrations compared with those that degenerated with ICSI. Oocytes that fertilized normally also came from follicles with higher estradiol (AOR=1.14) and progesterone (AOR=1.09) concentrations compared with those that failed to fertilize.


CONCLUSIONS
The hormonal profile of the follicular fluid yielding a degenerative egg or an egg that fails to fertilize is different from that resulting in normal fertilization. Higher follicular fluid estradiol may be a marker for oocytes that will fertilize normally with ICSI.
Lamb
Julie D
JD
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California at San Francisco, San Francisco, California 94115-0916, USA.
Zamah
A Musa
AM
Shen
Shehua
S
McCulloch
Charles
C
Cedars
Marcelle I
MI
Rosen
Mitchell P
MP
D000328:Adult; D003940:Diagnostic Techniques, Endocrine; D005260:Female; D005306:Fertilization / Q000502:physiology; D015571:Follicular Fluid / Q000737:chemistry* / Q000378:metabolism; D012739:Gonadal Steroid Hormones / Q000032:analysis* / Q000378:metabolism / Q000502:physiology; D006801:Humans; D007246:Infertility / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D010062:Ovulation Induction; D011247:Pregnancy; D011379:Prognosis; D020554:Sperm Injections, Intracytoplasmic; D016896:Treatment Outcome; D054928:Validation Studies as Topic
D012739:Gonadal Steroid Hormones