Follicular Fluid

Biochemical markers in follicular fluid could be reliable criteria to select those oocytes with optimal quality for transfer. 

Estradiol levels in follicular fluid correlate significantly with cleavage rate and with pregnancy in some studies (A3, B9, C2, W4), but not all (H5). In pooled follicular fluid, estradiol level is not associated with pregnancy (Fll, Ml2). It seems that the most estrogenic follicles are the major source of fertilizable oocytes. 

IGF-I is found in follicular fluid, and dominant follicles have three times higher IGF-I concentrations in follicular fluid compared to cohort follicles in normalcycling women (E2). 

After isolation of the oocytes, the follicular fluid from each patient was pooled, and after isolating the contaminating cells from the follicular fluid, the fluid was stored at -70°C until IGF-I determination. IGF-I was measured by radioimmunoassay (Nichols Institute Diagnostics, San Juan Capistrano, CA, USA). 

Difference in IGF-I Levels between Patients When Looking at Number of Ampoules of FSH Administered, Number of Follicles Aspirated, and Duration of Stimulation 

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The follicular phase covers the development of the follicle, which involves an increase in its size due to an increase in follicular fluid, growth of the ovum (i.e. an increase in the contents of RNA and protein) and an increase in the number of cells that surround the ovum. These cells are of two types, the granulosa and the thecal cells. The role of these cells is to synthesise and secrete the steroid hormones oestrogens (mainly oestradiol). The precursor molecule for their synthesis is cholesterol. There is a division of labour between these cells the thecal cells convert cholesterol into the male sex hormones androstenedione and testosterone, which are released into the blood to be taken up by the granulosa cells where they are converted to the oestrogens (Figure 19.8). For details of pathways, see Appendix 19.1. 

Follicular fluid mutagenicity. In 24 patients, 12 smoking and 12 nonsmoking, who were treated in an in vitro fertilization program, the mutagenicity of follicular fluid was not influenced by the number of cigarettes smoked. However, urine samples of... 

Thijssen, and T. K. Eskes. Is there NT332 influence of smoking on the mutagenicity of follicular fluid Fertil Steril 199 52(5) 774-777. 

Endocrine estradiol, estradiol Benzo- follicular fluid of... 

Other possible ovarian regulators include tumour necrosis factor-alpha, catecholaminergic input, luteinization inhibitor, gonadotrophinbinding inhibitors, oocyte maturation inhibitor and the ovarian renin-angiotensin system. Ovarian renin-angiotensin has been detected in follicular fluid (Lightman et al., 1989). 

Baukloh V, Bohnet HG, Trapp M, Heaschen W, Feichtinger W, Kemeter P (1987) Biocides in human follicular fluid. Ann NY Acad Sci, 442 240-250. 

Jarrell JF, Villeneuve D, Franklin C, Bartlett S, Wrixon W, Kohut J, Zouves CG (1993) Contamination of human ovarian follicular fluid and serum by chlorinated organic compounds in three Canadian cities. Can Med Assoc J, 148 1321-1327. 

Tozer AJ, lies RK, Iammarrone E, Gillott CMY, Al-Shawaf T, Grudzinskas JG. The effects of coasting on follicular fluid concentrations of vascular endothelial growth factor in women at risk of developing ovarian hyperstimulation syndrome. Hum Reprod 2004 19 522-8. 

IgG is found in ovarian (intra)follicular fluid or corpus lutea secondary to ovarian (ovulation) hemorrhage or macrophage-mediated transport. Macrophages have been localized to ovarian stroma, to thecal layers of ovarian follicles, and within early, mid-, late, and regressing corpora lutea [162],... 

One rare phenomenon occurring in patients undergoing IVF is empty follicle syndrome, the failure to aspirate oocytes from follicles. This can be predicted by measuring beta human chorionic gonadotropin levels 36 h after hCG administration (i.e., at the time of oocyte retrieval) (N4). Women with empty follicle syndrome have significantly lower levels of beta-hCG (range 0-9 mU/mliter) than controls without the empty follicle syndrome (range 106-290 IU/liter) (N4). The fact that this syndrome occurs only very rarely, and that at the time the beta-hCG level is known, the laboratory also has concluded that no oocytes are present in the follicular fluid, makes this test not very practical for everyday use. 

The mean concentration of IGF-I in follicular fluid was 129 67 ng/ml (mean SD). Linear regression analysis showed that IGF-I concentrations were significantly and inversely correlated with both the number of ampoules of FSH administered (Pearson s correlation coefficient = —0.405, p = 0.001) and with the number of days of FSH administration (Pearson s correaltion coefficient = -0.249, p = 0.039). 

Glycosaminoglycanes are present in follicular fluid, and the glycosaminogly-canes chondroitin sulfate and heparan sulfate have been shown to be related to... 

Placenta protein 14 was measured in follicular fluid and found to be significantly higher in conception compared to nonconception cycles (C6). 

An increase in alfal-antitrypsin in follicular fluid is associated with pregnancy (P8), but the correlation is not strong enough for alfal-antitrypsine to be an adequate marker for IVF treatment outcome. 

Follicular fluid and granulosa cells derived at ovum pickup in an IVF treatment, can reflect the qualities of the follicle, and therefore the oocyte. 

A3. Andersen, C. Y., Concentrations of free oestradiol and progesterone in human preovulatory follicular fluid. Hum. Reprod. 6, 359—364 (1991). 

B4. Basuray, R., Rawlins, R. G., Radwanska, E., Henig, I., Sachdeva, S., et al., High proges-terone/estradiol ratio in follicular fluid at oocyte aspiration for in vitro fertilization as a predictor... 

B6. Beilin, M. E., Ax, R. L., Laufer, N., Tarlatzis, B. C., DeCherney, A. H., et al., Glycosamino-glycans in follicular fluid from women undergoing in vitro fertilization and their relationship to cumulus expansion, fertilization, and development. Fertil. Steril. 45, 244—248 (1986). 

B9. Botero-Ruiz, W., Laufer, N., DeCherney, A. H., Polan, M. L., Haseltine, F. P., and Behrman, H. R., The relationship between follicular fluid steroid concentration and successful fertilization of human oocytes in vitro. Fertil. Steril. 41, 820-826 (1984). 

C6. Chryssikopoulos, A., Mantzavinos, T., Kanakas, N., Karagouni, E., Dotsika, E., and Zourlas, P. A., Correlation of serum and follicular fluid concentrations of placental protein 14 and CA-125 in in vitro fertilization-embryo transfer patients. Fertil. Steril. 66, 599-603 (1996). 

D2. Derkx, F. H., Alberda, A. T., Zeilmaker, G. H., and Schalekamp, M. A., High concentrations of immunoreactive renin, prorenin and enzymatically-active renin in human ovarian follicular fluid. Ur. J. Obstet. Gynaecol. 94, 4-9 (1987). 

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