THE RELATIONSHIP OF HUMAN GRANULOSA-LUTEIN CELL PROLIFERATIVE INDEX TO FOLLICULAR DIAMETER AND SERUM ESTRADIOL

Objective: To examine the relationships of follicular diameter and ser um estradiol (E2) to the percentage of granulosa cells undergoing mito sis as reflected by the proliferative index of granulosa cells. Method s: In this prospective study, we enrolled 44 consecutive women undergo ing controlled ovarian hyperstimulation for in vitro fertilization. De oxyribonucleic acid histograms were generated by flow cytometry from g ranulosa cells isolated at the time of transvaginal aspiration. Prolif erative index was defined as the sum of G(2)/M and S phases. We assess ed the correlation between proliferative index and age, maximum serum E2, number of oocytes retrieved, percent mature oocytes, and follicula r diameter. Results: Follicles less than 16 mm had a significantly hig her proliferative index (19.9 +/- 3.3%) than follicles 20 mm or greate r (14.8 +/- 3.9%, P =.016). However, there was no significant differen ce between proliferative index of the latter group and proliferative i ndex of follicles 16-19 mm (17.8 +/- 4.7%). An inverse correlation bet ween patient age and proliferative index of granulosa cells was noted (r = -.39, P =.018). There was no significant relationship between ser um E2 and proliferative index (P =.97). Conclusion: Mitotic activity t ends to decrease as follicular diameter increases after a threshold di ameter is achieved. Proliferative index of granulosa cells provides in sight into the underlying cell biology of a follicle. (C) 1998 by The American College of Obstetricians and Gynecologists.