Assessment of the follicular cortisol : cortisone ratio

Cortisol and cortisone concentrations in serum and follicular fluid (FF) fr om women undergoing in-vitro fertilization (IVF) treatment were monitored, Four groups were included: group 1, women in their natural menstrual cycle having an endogenous mid-cycle surge of gonadotrophins; group 2, women in t heir natural menstrual cycle receiving human chorionic gonadotrophin (HCG) for ovulation induction; group 3, women receiving exogenous gonadotrophins for ovarian stimulation and HCG for ovulation induction; and group 4, women receiving exogenous gonadotrophins for ovarian stimulation, follicles bein g aspirated immediately before administration of HCG. In this study, 12 fol licles contained oocytes which resulted in clinical pregnancy after IVF, Co rtisone concentrations were significantly higher in FF compared with that o f matched serum samples, while the opposite was observed for cortisol, resu lting in cortisol:cortisone ratios being significantly lower in FF compared with serum, FF from group 4 showed significantly higher cortisone concentr ations than FF from each of the other three groups. FF from group 1 showed significantly higher cortisone concentrations and significantly lower corti sol:cortisone ratios in comparison with groups 2 and 3. None of the observe d parameters pinpointed any of the follicles containing oocytes which resul ted in a clinical pregnancy, The intrafollicular concentrations of cortisol and cortisone suggest that pre-ovulatory follicles actively convert cortis ol to cortisone, Neither FF concentrations of cortisol and cortisone nor th e cortisol:cortisone ratio seem to reflect implantation potential of the de rived pre-embryos.