Estradiol and luteinizing hormone concentrations in the follicular aspirate during ovum pickup as predictors of in vitro fertilization (IVF) outcome

Background: A relationship between 'oocyte quality' and follicular fluid hormones is expected, since its formation coincides with the 'oocyte maturation' phase. The aim of this study was to find a possible relation between oocyte quality with follicular luteinizing hormone (LH) and estradiol (E2) as hormonal parameters of oocyte quality during ovum pickup for intra-cytoplasmic sperm injection (ICSI). Methods: Concentrations of LH and E2 in individual follicular fluid samples obtained during assisted reproduction treatment were related to oocyte nuclear maturation, fertilization and embryo grading. E2 and LH differences between individual groups of oocytes and embryos were calculated using the paired Student's t test and ANOVA test. Results: Follicular E2 levels showed a significant positive correlation with oocyte nuclear maturation, fertilization and embryo grading being higher in follicles whose oocytes had matured nucleus (475 ± 142.9 ng/ml vs. 332 ± 76.4 ng/ml, P value <0.001), normally fertilized (502.5 ± 131.3 ng/ml vs. 339.8 ± 78.3 ng/ml, P value <0.001) and developed into good quality embryos (596.9 ± 72.4 ng/ml grade A vs. 511.7 ± 73 ng/ml grade B vs. 310.9 ± 57 ng/ml grade C, P value <0.001). However Follicular LH was only positively correlated with oocyte nuclear maturation. Conclusions: The local follicular environment may play a key role in the observed differences in oocyte quality. Our results suggest that the use follicular E2 may be of value in the assessment of oocyte quality. If there is a marker for oocyte quality, it would be possible to select oocytes rather than embryos, which may improve selection criteria of the best embryo to transfer, therefore increases success rate of ICSI.