Evaluation of the relationship between follicular fluid oxidative stress, ovarian hormones, and response to gonadotropin stimulation

Objective: To investigate the relationship between oxidative stress and the underlying causes of infertility, preovulatory ovarian hormones, and ovarian response to gonadotropin stimulation in patients undergoing assisted reproductive techniques. Design: Prospective, cross-sectional study. Setting: Assisted conception unit, university hospital. Patient(s): One hundred thirty women presenting with infertility, of the following types: mate factor (n = 56), unexplained (n = 36), tubal factor (n = 16), polycystic ovary syndrome (n = 15), and endometriosis (n = 7). Intervention(s): Follicular fluid (FF) and peripheral blood samples were collected at oocyte retrieval. Main Outcome Measure(s): Blood and FF samples were analyzed for inhibin A, inhibin B, activin A, anti-Mullerian hormone, and E, by using ELISA. Total antioxidant capacity (TAC) was measured in plasma and FF by using a calorimetric microplate assay. Result(S): There was no significant relationship between plasma or FF TAC and the underlying etiology of infertility. There was a statistically significant positive association between FF E-2 levels and TAC (r = 0.26). Higher antral follicle count, delta E-2 (day 3 E-2 minus day 2 E-2), preovulatory serum anti-Mullerian hormone, inhibin B, and E-2 were associated with good ovarian response, whereas higher FF E-2 was associated with a statistically significant poor response. No significant direct relationship was observed between TAC and ovarian response as well as between TAC or any of the parameters measured and pregnancy outcome. Conclusion(s): Oxidative stress has an impact on the production of granulosa cell steroid hormones, in particular E-2, which is an important predictor of ovarian response. The positive association between FF E-2 and total antioxidant capacity suggests that E-2 may play a role in the ovarian antioxidant-oxidant balance. Objective: To investigate the relationship between oxidative stress and the underlying causes of infertility, preovulatory ovarian hormones, and ovarian response to gonadotropin stimulation in patients undergoing assisted reproductive techniques.