INCREASED FOLLICULAR-FLUID TOTAL AND FREE CORTISOL-LEVELS DURING THE LUTEINIZING-HORMONE SURGE

Objective: To determine the changes in follicular fluid (FF) total and free cortisol during the LH surge in naturally ovulating women. Patie nt(s): Twenty-six women having diagnostic laparoscopy during the folli cular phase of normal menstrual cycles were selected. Intervention(s): Blood samples were collected 1 day before, the day of, and 1 day afte r surgery and the results of serum E-2 and LH were used to divide the cycles retrospectively into pre- and post-LH surge groups. Follicular fluid was collected during laparoscopy. Main Outcome Measure(s): Serum P, total and free cortisol, and FF volume, E-2, P, total cortisol, an d free cortisol were measured on the day of surgery. Result(s): Median serum and FF P levels were significantly higher in the post-LH surge group compared with the pre-LH surge group (0.54 versus 1.54 ng/mL [1. 7 versus 4.85 nmol/ L] and 5.03 versus 28.0 mu g/mL [15.8 versus 88.0 mu mol/L], respectively). Follicular fluid volume also increased signi ficantly after the surge (2.5 versus 4.5 mL). Median serum total and f ree and percent free cortisol were higher after the surge, although no t significantly. In contrast, FF total, free, and percent free levels increased dramatically between pre- and post-LPI surge samples (4.41 v ersus 43.6 ng/mL [16.0 versus 158 nmol/L], 0.138 versus 6.68 ng/mL [0. 5 versus 24.2 nmol/L], and 3.3% versus 15.0%, respectively; P < 0.05). Conclusion(s): An increase in total and free cortisol occurs in the f ollicle during the LH surge. Cortisol and its regulation by 11 beta-hy droxysteroid dehydrogenase therefore may exert a physiologic role in o ocyte maturation or ovulation. (C) 1997 by American Society for Reprod uctive Medicine.