FOLLICULAR-FLUID CONTENTS OF HYALURONIC-ACID, FOLLICLE-STIMULATING-HORMONE AND STEROIDS RELATIVE TO THE SUCCESS OF IN-VITRO FERTILIZATION OF HUMAN OOCYTES

Objectives: To determine the concentrations of hyaluronic acid, FSH, P , and E(2) in the follicular fluid (FF) obtained from IVF-ET patients and to assess the value of these measurements in predicting the outcom e of fertilization. Design: One hundred eleven samples were retrospect ively analyzed for the hyaluronic acid and hormone contents. Setting: University-based tertiary care center. Patients: Preovulatory FF sampl es were collected from 67 women undergoing IVF-ET treatment because of tubal absence or obstruction. Main Outcome Measures: The FF hyaluroni c acid and hormone concentrations were compared according to the type of ovulation induction, follicular development, and IVF outcome. Resul ts: According to the type of ovulation induction, a significantly lowe r hyaluronic acid concentration was found in FF harvested from the pat ients treated with GnRH agonist-hMG. No significant correlation was fo und between FF hyaluronic acid and either morphological maturity of th e oocyte-cumulus complex or fertilizability of oocytes. The level of F SH was significantly higher in FF, yielding a mature oocyte-cumulus co mplex and from which the oocyte obtained successfully fertilized and c leaved. A significant increase in the E(2) concentration was found in FF in which mature cumuli oophori were present. The levels of hyaluron ic acid significantly correlated with FSH in FF. Conclusions: Expansio n of the human oocyte-cumulus cell complex is an FSH-dependent phenome non. The data are in agreement with the hypothesis that intrafollicula r FSH plays an important role in the secretion of hyaluronic acid by g ranulosa cells and may act synergistically with E(2) to enhance cytopl asmic maturation, resulting in successful fertilization.