Comparison of follicular fluid hormones in patients with one or two ovaries participating in a program of in vitro fertilization

Abstract

The authors recently reported on the follicular response to clomiphene citrate (CC) and human menopausal gonadotropins (hMG) in patients with one or two ovaries participating in a program of in vitro fertilization. This study was designed to analyze the follicular fluid hormones in patients with one or two ovaries in order to elucidate the compensatory mechanisms by which a single ovary achieves folliculogenesis equal to that of two ovaries. Twenty-one follicles from ten patients with one ovary were compared to 30 follicles from eight patients with two ovaries present. Ovulation induction was achieved using a standard protocol with sequential CC and hMG. Human chorionic gonadotropin (hCG) was administered after appropriate estradiol (E2) values and ultrasonic findings, and oocyte aspiration by laparoscopy was performed 33 hours later. Follicular fluid (FF) hormones were assayed by standard radioimmunoassay techniques and no differences were found in the levels of progesterone (P), testosterone, estradiol/testosterone ratio, prolactin, follicle-stimulating hormone, and luteinizing hormone. However, follicles from patients with one ovary had a lower mean concentration of E2 (286 versus 542 ng/ml, P = 0.001) and a lower mean E2/P ratio (0.055 versus 0.107, P = 0.016). Also, the mean follicular diameters and volumes were similar in both groups. In view of the authors' previous finding of a comparable number of mature oocytes from patients with either one or two ovaries, these data suggest that follicles from patients with a single ovary may achieve comparable oocyte maturity despite less efficient production of E2. Although FF E2 levels were lower in patients with one ovary, this dysynchrony between oocyte maturity and FF E2 values does not appear to affect outcome adversely.