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Human Reproduction, Vol. 18, No. 8, 1613-1617, August 2003
© 2003 European Society of Human Reproduction and Embryology

Cortisol and cortisone in human follicular fluid and serum and the outcome of IVF treatment

Sabina Lewicka1,3, Cornelia von Hagens2, Ute Hettinger1, Klaus Grunwald2, Paul Vecsei*,1, Benno Runnebaum2 and Thomas Rabe2

Departments of 1 Pharmacology and 2 Gynecology, University of Heidelberg, 69120 Heidelberg, Germany

3 To whom correspondence should be addressed at: Institute of Pharmacology, University of Heidelberg, Im Neuenheimer Feld 366, D-69120 Heidelberg, Germany. e-mail: sabina.lewicka{at}urz.uni-heidelberg.de

BACKGROUND: The glucocorticoid status of ovarian follicular fluid has been linked to oocyte quality. The aim of this study was to examine whether the concentrations of cortisone and cortisol and their calculated ratios in the follicular fluid and serum samples are predictive of IVF outcome. METHODS: In the prospective study of 387 patients (420 treatment cycles) undergoing IVF treatment the concentrations of cortisone and cortisol were measured with specific assays, and their calculated ratios in the follicular fluid and serum samples obtained after ovarian stimulation and induced ovulation were determined. RESULTS: In 75 patients, treatment resulted in clinical pregnancy and was associated with significantly lower follicular cortisone (24 ± 12 versus 29 ± 16 nmol/l, P < 0.002) and higher cortisol/cortisone ratio (7.24 ± 2.22 versus 6.45 ± 2.17 nmol/l, P < 0.007). In addition, the ratios of serum cortisone and cortisol to follicular cortisone and cortisol were significantly higher in those women who became pregnant. CONCLUSIONS: We propose that the follicular fluid glucocorticoid concentration resulting from the conditions in the circulation and the course of the intrafollicular cortisol–cortisone interconversion appear to play a role in the outcome of IVF.

Keywords: cortisol/cortisone/follicular fluid/IVF

* Dr Paul Vecsei died on July 7, 2002.


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