Abstract
Prior studies demonstrate the existence of an ovarian renin-angiotensin-aldosterone system (RAAS), although its precise function is unknown. Aldosterone (Ald), previously known only for its renal sodium regulation, is present in human follicular fluid (FF) and may be important for the development of oocytes. Our study examines the relationship between FF Ald levels and fertility treatment outcomes. Observational cohort study. TableMineralcorticoid ContentSerumFFAld (pg/mL)42 (11)∗480 (89)∗CS (pg/mL)<3900∗∗169930 (83825)Concentration Mean (STDEV); ∗P value<0.0001; ∗∗reference range. Open table in a new tab Concentration Mean (STDEV); ∗P value<0.0001; ∗∗reference range. Serum and FF was obtained from young (<35 years) and older (≥40 years) IVF patients at the time of vaginal oocyte retrieval. Some FF samples were separated by size exlusion HPLC and molecular weight estimation established by light scattering. Quantification of Ald and corticosterone (CS) was accomplished by ELISA. Comparison of means and correlations were performed with student t-test and Pearsons coefficient respectively. FF Ald levels were much greater than serum levels and high concentrations of Ald and its precursors were found in FF suggesting local synthesis (Table). Concentrations of FF cholesterol (Chol) and aldosterone were correlated (R = 0.34). The level of aldosterone was increased in FF from lead (≥16 mm) vs. small (≤12 mm) follicles (480 vs. 398 pg/mL, P=0.015). HPLC fractions from pregnant patients had higher concentration for all fractions including free content (fractions 25–27, Figure). The distribution profile for pregnant vs. non-pregnant patients differed suggesting variable complexation. Aldosterone is concentrated within follicular fluid to levels indicative of local synthesis. It's association with pregnancy and lead follicles suggests that aldosterone plays a role in the development of fertility competent follicles and oocytes.
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