Naa. Ebbiary et al., FOLLICULOCENTESIS - A NOVEL RESEARCH TECHNIQUE TO INVESTIGATE THE INTRAFOLLICULAR ENDOCRINE MICROENVIRONMENT, Human reproduction, 10(9), 1995, pp. 2325-2333
During development of the dominant follicle, the avascular granulosa c
ells and oocyte are exposed to the follicular fluid endocrine microenv
ironment. An alteration in the endocrine characteristics of follicular
fluid affects follicular steroidogenesis, oocyte maturation, ovulatio
n and subsequent corpus luteum function, In-vitro studies on pooled fo
llicular fluid from ovarian specimens lacked temporal precision betwee
n menstrual and follicular endocrine events. We have established a new
technique, termed folliculocentesis (FC), to sample follicular fluid
from the dominant ovarian follicle without compromising its growth or
function during the mid- to late follicular phase. A total of 38 subje
cts with regular ovulatory cycles each underwent two identical cycles
of hormone and follicle growth monitoring: one cycle served as the con
trol, and FC was performed during the second cycle, During all cycles,
plasma luteinizing hormone (LH), oestradiol and ultrasound monitoring
of follicle growth were commenced on day 7 and continued until after
ovulation, During FC cycles, 200 mu l of follicular fluid were aspirat
ed from the dominant follicle using transvaginal ultrasound guidance w
hen the follicle diameter reached greater than or equal to 10 mm. Six
subjects were excluded from the study because of incomplete or invalid
endocrine data, In all, 32 subjects completed both the FC and control
cycles, The follicle growth pattern, maximum follicle diameter, plasm
a oestradiol, oestradiol peak, plasma LH, LH surge and follicular phas
e length were similar during FC and control cycles, A total of 50 vali
d follicular fluid samples were obtained when the dominant follicle wa
s sampled once, twice or three times during the same cycle and from th
e same follicle in 15, 16 and one subjects respectively, The follicula
r fluid samples contained steroid concentrations consistent with those
of the mid- to late follicular phase, We conclude that the FC procedu
re is safe, easy to perform and does not affect follicle growth or hor
mone dynamics. Analysis of the follicular fluid samples is expected to
provide us with valuable in-vivo information about ovarian endocrinol
ogy.