title: Exploratory study of the association of steroid profiles in stimulated ovarian follicular fluid with outcomes of IVF treatment.
abstract: Steroid concentrations in stimulated follicular fluid (sFF) samples have been linked to the quality of oocytes used in IVF treatments. Most of the published studies focused on evaluating the association of the IVF outcomes with only a few of the steroids, measured by immunoassays (IA). We performed a treatment outcome, prospective cohort study using stimulated FF sampled from 14 infertile women undergoing IVF treatment; single oocyte was used per IVF cycle. Fourteen endogenous steroids were analyzed in 22 ovarian follicle aspirations, which corresponded to the embryos used in the IVF. Ten oocytes were associated with live birth (LB) and 12 with no pregnancy (NP). Steroids were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods. Differences in distribution of concentrations in association with the pregnancy outcome (LB or NP), and receiver operating characteristic (ROC) curves analysis were performed for the entire cohort and for within-women data. The predominant androgen and estrogen in stimulated sFF were androstenedione (A4) and estradiol (E2), respectively. Lower concentrations of pregnenolone (Pr), lower ratios of A4/ dehydroepiandrosterone (DHEA), testosterone (Te)/DHEA, and greater ratios of E2/Te, and estrone/A4 were observed in sFF samples associated with LB. Among the oocytes associated with NP, in four out of 12 samples total concentration of androgens was above the distribution of the concentrations in the oocytes corresponding to the LB group. Observations of the study indicated increased consumption of precursors and increased biosynthesis of estrogens in the follicles associated with LB. Our data suggest that potentially steroid profiles in sFF obtained during oocyte retrieval may serve as biomarkers for selection of the best embryo to transfer after IVF.
authors.affiliation: ARUP (®) Institute for Clinical and Experimental Pathology, Salt Lake City, USA; Department of Pathology, University of Utah School of Medicine, Salt Lake City, USA; Analytical Chemistry/Department of Chemistry, Biomedical Center and SciLife Laboratory, Uppsala University, Uppsala, Sweden. Electronic address: kushnmm@aruplab.com.
authors.forename: Mark M
authors.initials: MM
authors.lastname: Kushnir
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Tord
authors.initials: T
authors.lastname: Naessén
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Kjell
authors.initials: K
authors.lastname: Wanggren
authors.affiliation: IVF Kliniken Falun, IVF Sweden, Falun, Sweden.
authors.forename: Julius
authors.initials: J
authors.lastname: Hreinsson
authors.affiliation: ARUP (®) Institute for Clinical and Experimental Pathology, Salt Lake City, USA; Department of Pathology, University of Utah School of Medicine, Salt Lake City, USA.
authors.forename: Alan L
authors.initials: AL
authors.lastname: Rockwood
authors.affiliation: Department of Pathology, University of Utah School of Medicine, Salt Lake City, USA; Department of Medicine, University of Utah School of Medicine, Salt Lake City, USA.
authors.forename: A Wayne
authors.initials: AW
authors.lastname: Meikle
authors.affiliation: Department of Pathology, University of Utah School of Medicine, Salt Lake City, USA; Analytical Chemistry/Department of Chemistry, Biomedical Center and SciLife Laboratory, Uppsala University, Uppsala, Sweden.
authors.forename: Jonas
authors.initials: J
authors.lastname: Bergquist
mesh_terms: D000328:Adult; D000735:Androstenedione / Q000032:analysis; D003687:Dehydroepiandrosterone / Q000032:analysis; D004958:Estradiol / Q000032:analysis; D004970:Estrone / Q000032:analysis; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000737:chemistry*; D006801:Humans; D007247:Infertility, Female; D050498:Live Birth; D009865:Oocytes / Q000737:chemistry / Q000166:cytology; D010062:Ovulation Induction; D011247:Pregnancy; D011284:Pregnenolone / Q000032:analysis; D011446:Prospective Studies; D013256:Steroids / Q000032:analysis*; D053719:Tandem Mass Spectrometry; D013739:Testosterone; D055815:Young Adult
chemical_list: D013256:Steroids; D004970:Estrone; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D004958:Estradiol; D011284:Pregnenolone
keywords: Follicular fluid; IVF; LC-MS/MS; Mass spectrometry; Steroids