Effect of Follicular Fluid Estradiol Level on Oocyte Quality, Fertilization and Pregnancy Outcome in Intracytoplasmic Sperm Injection Cycles

Abstract Background Infertility is the third most serious disease worldwide estimated by the WHO. Despite the worldwide use of ICSI, it still has a low birth rate (30%). Patients and Methods The current study was a prospective study that included 180 women undergoing Intra-cytoplasmic sperm injection (ICSI) procedure. Using Flexible Antagonist protocol; during oocyte retrieval, follicular fluids of mature follicles (>17 mm) aspirated. Results The number of retrieved oocytes ranged from (1 to 33 oocytes) mean number 10±7. Follicular fluid E2 concentration ranged from 246±199 (0 to 700) (ng/ml). Oocyte maturation about 116 were MII (64.4%) of oocytes. And 64 (35.6%) were MI and GV. 107 cases (59.4) had normal fertilization [email protected] and 73(40%) had abnormal fertilization of MII injected oocytes. Embryo quality 63.9% (115) of fertilized MII oocytes were blastocysts and 65 (blastomere and others) and 60.6% of cases had embryo transfer on day 5 and 39.4 had transfer on day 3. Chemical pregnancy was positive in 85 cases (47.2%) and the clinical pregnancy positive in 66 cases (%). Conclusion Follicular fluid E2 concentration had fair predictive value in oocyte maturation, fertilization, embryo quality, chemical and clinical pregnancy. But it was an independent predictor of MII-grade oocytes production.

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Estradiol and leptin as conditional prognostic IVF markers

Reproduction ◽

10.1530/rep.1.00567 ◽

2005 ◽

Vol 129 (4) ◽

pp. 531-534 ◽

Cited By ~ 21

Author(s):

G Anifandis ◽

E Koutselini ◽

K Louridas ◽

V Liakopoulos ◽

K Leivaditis ◽

...

Keyword(s):

Follicular Fluid ◽

Embryo Quality ◽

Oocyte Retrieval ◽

Dependent Manner ◽

Ivf Outcome ◽

Concentration Dependent Manner ◽

Conditional Interaction ◽

Estradiol Levels ◽

Ivf Et

We studied the concentration of serum estradiol and serum and follicular fluid leptin in 200 women undergoing their first in vitro fertilization with embryo transfer (IVF-ET) program at the time of human chorionic gonadotrophin administration and oocyte retrieval, in an attempt to assess their concerted role on embryo quality and the prognosis of IVF outcome. Low serum (46.49 ± 8.4 ng/ml) and follicular fluid (52 ± 9.8 ng/ml) leptin levels were associated with a high number of ‘good-quality’ embryos (73.6%) and high implantation (11.2%) and pregnancy (35.8%) rates and were observed in women with normal peak estradiol levels of between 1000 and 2000 pg/ml. It appears that leptin and estradiol interact coordinately in a concentration-dependent manner to control IVF outcome. Further studies will be required to substantiate and clarify the mechanism of proposed conditional interaction between the two hormonal systems.

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Evaluation of Presepsin as a Predictive Marker in Women Undergoing ICSI

European Journal of Biology and Biotechnology ◽

10.24018/ejbio.2020.1.6.116 ◽

2020 ◽

Vol 1 (6) ◽

Author(s):

Bushra Rasheed Al-Azawea ◽

Hayder A. L. Mossa ◽

Liqaa R. Altamimi ◽

Lubna Amer Al-Anbary

Keyword(s):

Follicular Fluid ◽

Intracytoplasmic Sperm Injection ◽

Ovarian Stimulation ◽

Predictive Marker ◽

Clinical Findings ◽

Clinical Pregnancy ◽

Infertile Women ◽

Poor Predictor ◽

Significant Difference ◽

Antagonist Protocol

Purpose: The purpose of this study was to determine the ability of using Presepsin as a biomarker to evaluate the clinical pregnancy rate in a cohort of couples undergoing ICSI in a sample of Iraqi population. Patients and Methods: Sixty infertile women selected for undergoing intracytoplasmic sperm injection, the patient’s ovarian stimulation were by antagonist protocol accordingly to their clinical findings. Results: The results of the study shows there was no significant difference in the serum Presepsin between pregnant and non-pregnant ladies, 421.57 (1534.65) versus 878.64 (1322.23), respectively (P = 0.875), Furthermore, there was no significant difference in follicular fluid Presepsin between pregnant and non-pregnant ladies, 1286.73 (1232.00) versus 0.00 484.15 (1467.00), respectively (P = 0.296). Conclusions :We conclude that serum or follicular fluid Presepsin as a biomarker is a poor predictor of fertility outcome with no significant difference between pregnant and non-pregnant ladies

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P–273 Effects of ovulation induction with GnRH Agonist (GnRHa) on oocyte and embryo quality at the mitochondrial level: A retrospective and experimental study

Human Reproduction ◽

10.1093/humrep/deab130.272 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

M Basar ◽

O Olcay ◽

B Akcay ◽

S Aydin ◽

M Neslihan ◽

...

Keyword(s):

Western Blot ◽

Oocyte Maturation ◽

Gnrh Agonist ◽

Embryo Quality ◽

Implantation Rate ◽

Oocyte Retrieval ◽

Treated Group ◽

Utilization Rate ◽

Oocyte Diameter ◽

Ovarian Hyperstimulation

Abstract Study question Does the GnRHa trigger improve oocyte and embryo quality in patients younger than 40, and do mtUPPR have a role? Summary answer GnRHa trigger improves oocyte nuclear/cytoplasmic maturation, blastocyst utilization and downregulates HSP60 levels and upregulates ATF5 levels compared to hCG trigger. GnRHa trigger suppresses mitochondrial stress. What is known already hCG has been used for decades to achieve final oocyte maturation and, thereby, correct oocyte retrieval timing in connection with ovarian hyperstimulation protocols. As an alternative to hCG, a GnRH agonist has been used to trigger the endogenous release of LH (and FSH) in a fashion resembling the mid-cycle surge of gonadotrophins. GnRHa is as effective as hCG for the induction of ovulation. It has been very well known that the GnRHa trigger improves oocyte nuclear maturation, embryo quality, and implantation rate, but the underlying mechanism remains unknown. Study design, size, duration 3054 women younger than 40; oocytes retrieved more than 10 (up to 20) analyzed. Male infertility was excluded. Ovulation triggered either by hCG (n = 1368) or GnRHa (1668). Female mice were divided into three groups as control, hCG-treated and GnRHa-treated group. Superovulation was performed by FSH + hCG or GnRHa. Oocytes were collected 13 hours after hCG/GnRHa injection. ATF5, BiP, and HSP60 levels were analyzed by Western blot. Statistical analysis was performed using Student’s t-test. Participants/materials, setting, methods This study has two parts. i) RCT and ii) Experimental. In the experimental part, three months old female BALB/C mice (25–30 g) were used and divided into three groups (n = 20/group) as control, hCG-treated and GnRHa-treated group. Superovulation was performed by administering an injection of 5 IU FSH (i.p.) and hCG (i.p.) or GnRHa (20 mg/kg) i.m. Oocytes were collected 13 hours after hCG/GnRHa injection. ATF5, BiP, and HSP60 levels were analyzed by Western blot. Main results and the role of chance The mean age (34.8 vs. 35.2 years), total gonadotropin dose (2176 vs. 2230 IU), and the number of oocytes picked up (14.9 vs. 13.4) were not statistically different among GnRHa and hCG group, respectively. No LH rise or any OHSS was noticed in any groups. Oocyte maturation (79.8% vs. 75.9%), oocyte diameter (as a marker of cytoplasmic maturity) (10198 µm2 and 9474 µm2), fertilization rate (78% vs. 72%), and embryo utilization rate (52% vs. 47.2%) were significantly higher in GnRHa group compared to hCG group, respectively. HSP60 level (activated by mtUPR) was statistically higher in the hCG group compared to the GnRHa group (55% vs. 22%, p < 0.05 respectively). On the other hand, the ATF5 level was significantly higher in the GnRHa group than the hCG group (p < 0.0001). Limitations, reasons for caution The limitation is that this is a proof-of-concept study to reveal the mechanism of good embryo quality with GnRHa trigger. Wider implications of the findings: This application offers convenience and simplifies the IVF protocol with a better oocyte and embryo quality while reducing Ovarian Hyperstimulation Syndrome (OHSS) risk during IVF care Trial registration number Not applicable

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Ovarian follicular function is not altered by SARS-Cov-2 infection or BNT162b2 mRNA Covid-19 vaccination

10.1101/2021.04.09.21255195 ◽

2021 ◽

Author(s):

Yaakov Bentov ◽

Ofer Beharier ◽

Arbel Moav-Zafrir ◽

Maor Kabessa ◽

Miri Godin ◽

...

Keyword(s):

Follicular Fluid ◽

Ovarian Function ◽

Ovarian Follicle ◽

Oocyte Retrieval ◽

Study Groups ◽

Oocyte Quality ◽

University Hospital ◽

Recent Infection ◽

Quality Reporting ◽

The Impact

AbstractImportanceThis is the first study to examine the impact of SARS-Cov-2 infection and COVID-19 vaccination on ovarian function.ObjectiveTo characterize anti-COVID-19 antibodies in follicular fluid and compare ovarian follicle function in women following confirmed SARS-CoV-2 infection, COVID-19 vaccination, and non-infected, unvaccinated controls.DesignThis is a cohort study conducted between February 1 and March 10, 2021.SettingA single university hospital-based IVF clinic.ParticipantsConsecutive sample of female patients undergoing oocyte retrieval.InterventionsConsenting patients were recruited and assigned to one of three study groups: recovering from confirmed COVID 19 (n=9); vaccinated (n=9); and uninfected, non-vaccinated controls (n=14). Serum and follicular fluid samples were taken and analyzed for anti-COVID IgG as well as estrogen, progesterone and HSPG2 concentration, as well as the number and maturity of aspirated oocytes and previous estrogen and progesterone measurements.Main outcome measuresFollicular function, including steroidogenesis, follicular response to the LH/hCG trigger, and oocyte quality biomarkers.ResultsBoth natural and vaccine elicited anti-COVID IgG antibodies were detected in the follicular fluid in levels proportional to the IgG serum concentration. No differences were detected in any of the surrogate ovarian follicle quality reporting parameters.Conclusions and relevanceBoth SARS-COV-2 infection and vaccination with the BNT162b2 mRNA vaccine mediate IgG immunity that crosses into the follicular fluid. No detrimental effect on follicular function was detected.Trial RegistrationCinicalTrials.gov registry number NCT04822012Key PointCOVID 19 disease and BNT162b2 mRNA vaccine induce anti-COVID IgG in follicular fluid; neither recent infection nor vaccination appear to negatively effect follicular function.

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An increase of phosphatidylcholines in follicular fluid implies attenuation of embryo quality on day 3 post-fertilization

BMC Biology ◽

10.1186/s12915-021-01118-w ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Ju Wang ◽

Wei Zheng ◽

Shuoping Zhang ◽

Keqiang Yan ◽

Miao Jin ◽

...

Keyword(s):

Arachidonic Acid ◽

Pathway Analysis ◽

Follicular Fluid ◽

Embryo Quality ◽

Evaluation Model ◽

Oocyte Quality ◽

Reproductive Technology ◽

Dominant Factor ◽

Clinical Conditions ◽

Informative Approach

Abstract Background Although oocyte quality is the dominant factor determining embryo quality, few studies have been conducted to evaluate embryo quality based on the metabolites related to the oocyte. With quantification of the follicular fluid (FF) metabolites, in assisted reproductive technology (ART), this study sought to evaluate the embryo or oocyte quality through an informative approach. Results An evaluation model consisting of 17 features was generated to distinguish the embryo quality on day 3 post-fertilization, and phosphatidylcholines (PCs) were the key contributors to the evaluation. The model was extended to the patients under different ages and hyperstimulations, and the features were further enriched to facilitate the evaluation of the embryo quality. The metabolites were clustered through pathway analysis, leading to a hypothesis that accumulation of arachidonic acid induced by PCs might weaken embryo quality on day 3 post-fertilization. Conclusions A discriminating model with metabolic features elicited from follicular fluid was established, which enabled the evaluation of the embryo or oocyte quality even under certain clinical conditions, and the increase of PCs in follicular fluid implies the attenuation of embryo quality on day 3 post-fertilization.

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Serum and follicular fluid concentration of stem cell factor in PCOS

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183754 ◽

2018 ◽

Vol 7 (9) ◽

pp. 3467

Author(s):

Ziya Kalem ◽

Müberra Namli Kalem ◽

Murat Seval ◽

Batuhan Bakirarar ◽

Coskun Simsir ◽

...

Keyword(s):

Follicular Fluid ◽

Oocyte Retrieval ◽

Clinical Pregnancy ◽

Reproductive Age ◽

Control Group ◽

Fluid Concentration ◽

Pcos Group ◽

Reproductive Aged Women ◽

Relationship Of ◽

The Relationship

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in reproductive-aged women, which affects 5 to 20% of women in the reproductive age worldwide. This study aimed to compare the levels of SCF in serum and follicular fluid of PCOS patients with those of non-PCOS group and to investigate the relationship of SCF levels with ICSI success.Methods: This is an observational case control study that included the patients who underwent ICSI in the Infertility-IVF center at Ankara University Faculty of Medicine and in a private IVF center between March 2016 and February 2017. The study group consisted of 57 PCOS patients diagnosed according to the Rotterdam criteria and the control group consisted of 75 patients with normofollicular and regular menstrual cycles. Serum and follicular fluid samples were taken on day of oocyte retrieval. Serum and follicular fluid SCF levels were determined by ELISA using the SCF ELISA kit..Results: Serum and follicular fluid SCF levels in PCOS patients were found to be lower than in non-PCOS group. sSCF and ffSCF were statistically significantly higher who had clinical pregnancy than those who had no clinical pregnancy in the PCOS group.Conclusions: SCF levels are low in serum and follicular fluid in patients with PCOS and that the increase in SCF levels is associated with an increase in oocyte maturation and clinical pregnancy rates in PCOS.

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Increased SCF in Follicular Fluid and Granulosa Cells Positively Correlates With Oocyte Maturation, Fertilization, and Embryo Quality in Humans

Reproductive Sciences ◽

10.1177/1933719117697125 ◽

2017 ◽

Vol 24 (11) ◽

pp. 1544-1550 ◽

Cited By ~ 8

Author(s):

Jun Tan ◽

Yang Zou ◽

Xing-Wu Wu ◽

Li-Feng Tian ◽

Qiong Su ◽

...

Keyword(s):

Oocyte Maturation ◽

Granulosa Cells ◽

Follicular Fluid ◽

Embryo Quality

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Successful Oocyte Retrieval, Fertilization, and Clinical Pregnancy with Low Serum β-hCG on the Day of Oocyte Collection: A Reappraisal of the Definition of the Empty Follicle Syndrome

Case Reports in Obstetrics and Gynecology ◽

10.1155/2020/9210651 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Nicole A. Van De Velde ◽

Charalampos Chatzicharalampous ◽

Awoniyi O. Awonuga

Keyword(s):

Oocyte Maturation ◽

Medical Center ◽

Academic Medical Center ◽

Preimplantation Genetic Screening ◽

Oocyte Retrieval ◽

Fertilization Rate ◽

Clinical Pregnancy ◽

Comparative Genomic ◽

Intrauterine Pregnancy ◽

Final Oocyte Maturation

Objective. To describe a case of successful oocyte retrieval, fertilization and clinical pregnancy despite very low β-hCG level, twelve hours after ovulation trigger. Design. Case report. Setting. Academic medical center. Patient. A 38-year-old patient inadvertently administered 2,000 IU hCG for final oocyte maturation; serum hCG twelve hours later was 16 IU/L. Interventions. Effort to obtain and administer a booster dose of hCG over the next twenty-seven hours failed. Main Outcome. Successful oocyte retrieval. Results. Fourteen oocytes were retrieved of which twelve were in metaphase II and nine fertilized after intracytoplasmic sperm injection (ICSI). Of these, eight embryos survived to day 5 and were subjected to preimplantation genetic screening (PGS) by comparative genomic hybridization (CGH). Results were available the next day, three of the embryos were euploid and one was transferred on day 6. Pregnancy was confirmed twelve days later and currently the patient has an ongoing singleton intrauterine pregnancy. Conclusion. Reproductive Endocrinology and Infertility specialists should be aware that final oocyte maturation could occur following injection of a lower dose of hCG with excellent fertilization rate and embryo development.

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A randomized Clinical Trial comparing embryo quality and clinical pregnancy rate in PCOS patients underwent controlled ovarian stimulation using antagonist protocol with freeze all strategy and triggered for final oocyte maturation by gonadotropin agonist versus human chorionic gonadotropin in IVF cycles

Obstetrics & Gynecology International Journal ◽

10.15406/ogij.2021.12.00592 ◽

2021 ◽

Vol 12 (5) ◽

pp. 279-282

Author(s):

Mahmoud Alalfy ◽

Wafaa Ramadan ◽

Rania Refaat

Keyword(s):

Clinical Trial ◽

Pregnancy Rate ◽

Randomized Clinical Trial ◽

Gnrh Agonist ◽

Embryo Quality ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Significant Difference ◽

Frozen Embryos ◽

Antagonist Protocol

Background: The use of Gonadotropin-releasing hormone (GnRH) antagonist protocol rather than the long agonist protocol showed a marked reduction in the incidence of OHSS Aim: To compare the effect of triggering oocytes by agonist versus HCG on reduction of risk of OHSS, embryo quality and clinical pregnancy rate. Patients and methods: A randomized Clinical Trial was conducted at IVF unit in Cairo University Obstetric and Gynecologic hospital. The patients were divided into two groups, the 1st group received GnRH agonist trigger, the 2nd group received hCG trigger; all embryos were frozen at day 5 and frozen embryos were transferred the next cycle. Results: There was an obvious reduction in the risk of OHSS in the GnRH agonist triggered group than in the HCG triggered group but with no statistically significant difference. In the current study, there was no statistically significant difference between the HCG triggered group in comparison to the GnRH agonist triggered group regarding chemical and clinical pregnancy rates. Conclusion: The use of GnRH triggering for women with PCOS undergoing ICSI cycle with antagonist protocol with freeze all and transfer of frozen embryos in a later cycle has a lower risk of OHSS than using HCG triggering method.

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The Effect Follicular Fluid Vitamin A, E, D and B6 on Embryo Morphokinetics and Pregnancy Rates in Patients Receiving Assisted Reproduction

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2018.860 ◽

2019 ◽

pp. 1

Author(s):

Funda Gode ◽

Suleyman Akarsu ◽

Zeliha Gunnur Dikmen ◽

Burcu Tamer ◽

Ahmet Zeki Isik

Keyword(s):

Vitamin A ◽

Follicular Fluid ◽

Significant Positive Correlation ◽

Embryo Quality ◽

Pregnancy Rates ◽

Clinical Pregnancy ◽

In Vitro Fertilisation ◽

Positive Correlation ◽

Morphokinetic Parameters ◽

Clinical Pregnancy Rates

Objective: To evaluate the associations among levels of vitamins A, E, D, and B6 in follicular fluid embryo morphokinetics and quality, and clinical pregnancy rates.Study Design: A total of 58 patients with unexplained infertility admitted to the in vitro fertilisation (IVF) centre of Izmir Medical Park Hospital were included in this prospective clinical study. For each patient, vitamin levels were assayed using high-performance liquid chromatography. After intracytoplasmic sperm injection, for each oocyte, the relationships between each vitamin and subsequent embryo quality, embryo morphokinetics, and clinical pregnancy rates were investigated. Embryos were classified as grade A, B, C, or D according to morphokinetic parameters using t5-t2 and t5-t3 (cc3). Results: There was no significant correlation between embryo morphokinetic parameters (tpnf, t2, t3, t4, t5, t6, t7 and t8) and follicular fluid vitamin (A, B6, D and E) levels (p>0.05). There was a significant positive correlation between t5optimal and follicular fluid vitamin A levels (p<0.05). There was a significant positive correlation between cc2optimal and follicular fluid vitamin B6 levels (p<0.05). Levels of vitamins A and B6 were significantly higher in grade A and B embryos than in grade C and D embryos. There were no significant relationships between vitamins E or D and embryo quality or between any vitamin and clinical pregnancy rates.Conclusion: High levels of vitamins A and B6 in follicular fluid are significantly associated with high-quality embryos and optimal morphokinetics. However, none of the vitamins considered showed a significant relationship with clinical pregnancy rates.

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