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Human Reproduction, Vol. 15, No. 9, 1909-1912, September 2000
© 2000 European Society of Human Reproduction and Embryology

Expected contribution to serum oestradiol from individual ovarian follicles in unstimulated cycles

David J. Cahill1,3, Peter G. Wardle1, Christopher R. Harlow1, Linda P. Hunt2 and Michael G.R. Hull1,*

1 University of Bristol Centre for Reproductive Medicine, St Michael's Hospital, Southwell Street and 2 University of Bristol Division of Child Health, Institute of Child Health, Royal Hospital for Sick Children, Bristol BS2 BEG, UK

Data relating serum oestradiol concentration to follicle size in unstimulated cycles are lacking. We provide precise data on serum concentrations expected for any follicle diameter (FD) in the mid- to late follicular phase. Infertile women (n = 35) with apparently normal ovulatory cycles were studied in detail in 128 unstimulated monofollicular cycles leading to IVF. Using mathematical modelling to account for repeated cycles in the same woman, the relationship between serum oestradiol and FD was explored and reference ranges for serum oestradiol at individual FD were calculated. Serum oestradiol concentrations [number of patients, geometric mean, 95% confidence interval (CI)] at the onset of the LH surge were higher in `fertilized' cycles (73, 1279, 1180–1378 pmol/l) compared with `unfertilized' cycles (31, 1055, 929–1197 pmol/l, P = 0.008) and `no oocyte' cycles (24, 1064, 922–1227 pmol/l, P = 0.03) respectively. In `fertilized' cycles, oestradiol concentrations rose exponentially with FD and for each size of follicle the oestradiol distribution was skewed. Functional oocyte competence varied in apparently normal ovulatory cycles and was correlated with pre-ovulatory serum oestradiol but not FD. Serum oestradiol varies within wide limits for maturing follicles of any given diameter prior to the onset of the LH surge.

Key words: competent oocytes/follicle diameter/monofollicular unstimulated cycles/serum oestradiol

3 To whom correspondence should be addressed at: University of Bristol Division of Obstetrics and Gynaecology, St Michael's Hospital, Southwell Street, Bristol BS2 BEG, UK. E-mail: d.j.cahill{at}bris.ac.uk

* After a short illness, Michael Hull, Professor of Reproductive Medicine and Surgery in the Division of Obstetrics and Gynaecology, University of Bristol, died on 22 November, 1999, aged 60 years. He went to Bristol from London in 1976 as Consultant Senior Lecturer in Obstetrics and Gynaecology with a developing reputation in clinical reproductive endocrinology from his time in London and elsewhere. His contributions to knowledge and practice of reproductive medicine, particularly in all aspects of male and female infertility, brought international renown to his unit. He was appointed to a Personal Chair in 1989. He brought strong ethical principles to his research and clinical practice and campaigned locally and nationally for public understanding and funding of infertility services.


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