CONTEXT:Various components of follicular fluid are suggested as biochemical predictors of oocyte quality. Previous studies of follicular steroid hormone levels have shown disparate results when related with fertilization outcomes.AIM:The objective of the study was to relate the levels of steroid hormones of each individual follicle with oocyte maturation, fertilization results, embryo quality, and pregnancy rates.SETTINGS AND DESIGN:Prospective cohort study in a university hospital.METHODS:In 31 patients, who underwent intracytoplasmic sperm injection, it was performed an ultrasound guided aspiration of follicular fluid of the first two mature follicles from each ovary. Follicular levels of estradiol, progesterone, testosterone, and dehydroepiandrosterone sulfate were measured by chemiluminescent immunoassay.STATISTICAL ANALYSIS:Generalized estimating equation model.RESULTS:In follicular fluids with mature oocyte presence, in normal as well as in failed fertilization, there was a positive correlation between follicular testosterone and progesterone (r = 0.794, P = 0.0001 and r = 0.829, P = 0.0001). Progesterone levels were higher in cases of normal fertilization compared to failed fertilization (P = 0.003). B quality embryos came from oocytes immersed in follicular fluids with higher estradiol values and higher estradiol/progesterone and estradiol/testosterone ratios than those of C quality (P = 0.01; P = 0.0009; P = 0.001). Estradiol levels were higher in patients who achieved pregnancy (P = 0.02).CONCLUSION:The analysis of follicular hormone composition could be considered as an additional tool in oocyte selection.

CONTEXT:There is disagreement as to whether the concentration of a substance in follicular fluid is related to the quality of the follicle as a possible reflection of the oocyte quality or whether this concentration is related to the clinical characteristics of the patient.AIM:To establish the variability of steroid hormone levels in follicular fluids from different follicles of the same patient and between patients.SETTINGS AND DESIGN:Prospective cohort study.MATERIALS AND METHODS:In 31 patients who underwent intracytoplasmic sperm injection it was performed an ultrasound guided aspiration of follicular fluid of the first two mature follicles from each ovary. Chemiluminescent microparticle immunoassays were performed to determine the levels of estradiol, progesterone, testosterone, and dehydroepiandrosterone sulfate (DHEA-S).STATISTICAL ANALYSIS:Unconditional mixed model.RESULTS:Variation in estradiol levels between follicles in the same patient was approximately twice the variation between subjects (P = 0.05). In the case of progesterone, the intra-subject variation was similar to the inter-subject variation (P = 0.006). The testosterone levels had a slightly smaller intra-subject variation than inter-subject variation (P = 0.002), and the intra-subject variation in DHEA-S levels was approximately one-fifth of the inter-subject variation (P = 0.0003).CONCLUSIONS:The variations in the levels of follicular progesterone and testosterone were similar between patients and between a given patient's follicles; however, the estradiol levels variability was higher among different follicles. The amount of follicular estradiol may be considered a selection tool between the follicles of a given patient.

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