ELEVATED FOLLICULAR-FLUID ANGIOTENSIN-II AND PREGNANCY OUTCOME

Objective: To assess whether a relationship exists between follicular fluid (FF) angiotensin II (AII) concentration and pregnancy outcome or earlier fecundity parameters and whether correlations exist among FF AII concentrations and P, E2, T, androstenedione (A), or various ratio s of these. Design: Retrospective study in which hormone concentration s in FF samples were measured. Setting: In vitro fertilization clinic- Assisted Reproductive Technology Program, Rush Medical Center. Patient s: Twenty-six female patients underwent ovarian stimulation for IVF. I ntervention: Leuprolide acetate was combined with hMG and FSH for ovar ian stimulation. Main Outcome Measure: Follicular fluid aspirates were collected and oocytes were recovered 34 to 36 hours after hCG injecti on. The patients proceeded to undergo IVF and ET. Follicular fluid hor mones were measured using standard RIA. Angiotensin II and steroid hor mone concentrations in FF were compared for pregnant versus nonpregnan t women using the Student's t-test and rank-sum test. Pearson multiple -correlation analysis was performed to calculate correlation coefficie nts among AII concentrations and steroid concentrations in FF aspirate s. Results: Mean FF concentration of AII was significantly lower in sa mples from women showing clinical pregnancies (112.2 +/- 13.9 pg/mL [1 07.3 +/- 13.3 pmol/L]) compared with samples from women who did not ac hieve pregnancy (217.1 +/- 23.8 pg/mL [207.5 +/- 22.7 pmol/L]) (mean /- SE). A negative correlation was observed between FF concentrations of AII and P. Correlations of AII with E2, T, A, or with ratios of the se did not show significance. Conclusion: These data suggest that high AII concentration at time of oocyte recovery may indicate poor pregna ncy outcome in women undergoing ovarian stimulation for IVF. These dat a corroborate previous results in animal models showing that AII predi sposes follicles to undergo atresia-like conditions.