THE SUITABILITY AND EFFICIENCY OF HUMAN FOLLICULAR-FLUID AS A PROTEIN-SUPPLEMENT IN HUMAN IN-VITRO FERTILIZATION PROGRAMS

Objective: To evaluate the suitability and efficiency of human follicu lar fluid (HFF) as a protein supplement in human TVF programs. Design: Comparative study of the effects of HFF and other protein supplements on the in vitro development of mouse oocytes and on the pregnancy rat e in human IVF programs. Setting: In Vitro Fertilization Center, Hanna Women's Clinic, Seoul, Korea. Patient(s): Three hundred twenty-seven patients (388 cycles) who were down-regulated with GnRH agonist and st imulated with hMG. Intervention(s): The suitability was evaluated with the results of animal studies and the efficiency of HFF was investiga ted with the results of human IVF programs. Main Outcome Measure(s): M eiotic maturation of mouse oocytes, development of mouse embryos, morp hological grades of human embryos, pregnancy rate in human NF programs , and electrophoresis. Result(s): Human follicular fluid significantly stimulated meiotic resumption in mouse oocytes, even in the presence of meiotic inhibitors, and enhanced the developmental potential of mou se embryos in vitro. Compared with human fetal cord serum, human folli cular fluid also improved the morphological grade of human embryos by reducing cytoplasmic fragmentation. In conventional TVF cycles of huma n IVF programs, use of HFF significantly increased the clinical PR (10 9/234 cycles, 46.54%; P < .05), compared with use of human fetal cord serum (14/52 cycles, 26.96). However, in intracytoplasmic sperm inject ion cycles, there was no difference in PRs between use of HFF (38/85 c ycles, 44.7%) and use of human fetal cord serum (7/17 cycles, 41.1%). When the protein compositions of human fetal cord serum and HFF were i nvestigated by electrophoresis, a protein of 21 kD was detected specif ically in HFF. Conclusion(s): Human follicular fluid is suitable for u se as a protein supplement and is effective in increasing the pregnanc y rate in human IVF programs. (Fertil Steril(R) 1998;70:871-7. (C) 199 8 by American Societp for Reproductive Medicine.).