title: Follicular fluid dehydroepiandrosterone sulfate is a credible marker of oocyte maturity and pregnancy outcome in conventional in vitro fertilization cycles.
abstract: OBJECTIVE
  To investigate if the level of dehydroepiandrosterone sulfate (DHEA-s) in follicular fluid (FF) influences the competence of oocytes to fertilize, develop to the blastocyst stage, and produce a viable pregnancy in conventional in vitro fertilization (IVF) cycles.
  
  
  METHODS
  Prospective study of age-matched, nonpolycystic ovary syndrome (PCOS) women undergoing antagonist stimulation protocol involving conventional insemination and day 5 blastocyst transfer.
  
  
  METHODS
  FF levels of DHEA-s and E2 were measured by a radio-immuno-assay method using diagnostic kits. Fertilization rate, embryo development to the blastocyst stage and live birth rate were main outcome measures. Cycles were divided into pregnant/nonpregnant groups and also into low/medium/high FF DHEA-s groups. Statistical analysis was done by GraphPad Prism V software.
  
  
  RESULTS
  FF DHEA-s levels were significantly higher in pregnant (n = 111) compared to nonpregnant (n = 381) group (1599 ± 77.45 vs. 1372 ± 40.47 ng/ml; P = 0.01). High (n = 134) FF DHEA-s group had significantly higher percentage of metaphase II (MII) oocytes (91.5 vs. 85.54 vs. 79.44%, P < 0.0001), fertilization rate (78.86 vs. 74.16 vs. 71.26%, P < 0.0001), cleavage rate (83.67 vs. 69.1 vs. 66.17%, P = 0.0002), blastocyst formation rate (37.15 vs. 33.01 vs. 26.95%, P < 0.0001), and live birth rate (29.85 vs. 22.22 vs. 14.78%, P = 0.017) compared to medium (n = 243) and low (n = 115) FF DHEA-s groups, respectively despite comparable number of oocytes retrieved and number of blastocysts transferred. FF DHEA-s levels correlated significantly with the attainment of MII oocytes (Pearson r = 0.41) and fertilization rates (Pearson r = 0.35).
  
  
  CONCLUSIONS
  FF DHEA-s level influences the oocyte maturation process and is predictive of fertilization, embryo development to the blastocyst stage and live birth rates in non-PCOS women undergoing conventional IVF cycles.
authors.affiliation: Department of Endocrinology, Vaunshdhara Clinic and Assisted Conception Centre, Nagpur, India; Department of Embryology, Vaunshdhara Clinic and Assisted Conception Centre, Nagpur, India.
authors.forename: Natachandra M
authors.initials: NM
authors.lastname: Chimote
authors.affiliation: Department of Biochemistry, Vaunshdhara Clinic and Assisted Conception Centre, Nagpur, India.
authors.forename: Nirmalendu M
authors.initials: NM
authors.lastname: Nath
authors.affiliation: Department of Embryology, Vaunshdhara Clinic and Assisted Conception Centre, Nagpur, India.
authors.forename: Nishad N
authors.initials: NN
authors.lastname: Chimote
authors.affiliation: Department of Embryology, Vaunshdhara Clinic and Assisted Conception Centre, Nagpur, India; Department of Biochemistry, Vaunshdhara Clinic and Assisted Conception Centre, Nagpur, India; Vaunshdhara Clinic and Assisted Conception Centre, Nagpur, India.
authors.forename: Bindu N
authors.initials: BN
authors.lastname: Chimote
keywords: Blastocyst; dehydroepiandrosterone sulfate; fertilization; in vitro fertilization; oocyte; pregnancy