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Higher cortisol:cortisone ratios in the preovulatory follicle of completely unstimulated IVF cycles indicate oocytes with increased pregnancy potential

Higher cortisol:cortisone ratios in the preovulatory follicle of completely unstimulated IVF cycles indicate oocytes with increased pregnancy potential
Higher cortisol:cortisone ratios in the preovulatory follicle of completely unstimulated IVF cycles indicate oocytes with increased pregnancy potential
BACKGROUND: Conception following gonadotrophin-stimulated IVF and embryo transfer has been associated with a higher intrafollicular cortisol:cortisone ratio and decreased metabolism of cortisol to cortisone. The role of glucocorticoids in human oocyte maturation is not fully understood, but active glucocorticoid (cortisol) may be important. This study relates intrafollicular cortisol and cortisone concentrations to oocyte fertilization and embryo implantation in unstimulated cycles. METHODS: Patients aged <40 years with favourable sperm underwent unstimulated IVF–embryo transfer. Study 1 related intrafollicular cortisol levels to oocyte and IVF outcome: (i) fertilized, pregnant (n = 9); (ii) fertilized, not pregnant (n = 21); and (iii) unfertilized (n = 12). Study 2 was a case–control study of 27 patients (same outcome groups of equal size) which measured intrafollicular cortisol, cortisone and the cortisol:cortisone ratio. RESULTS: Conception cycles demonstrated higher cortisol concentrations compared with the fertilized group (study 1) [median (95% confidence interval): 299 (249–330) versus 227 nmol/l (185–261); P < 0.05] and higher cortisol:cortisone ratios when compared with the unfertilized group (study 2) [7.38 (5.23–9.19) versus 3.56 (1.75–7.46) respectively; P = 0.02]. Of the women with cortisol:cortisone ratios greater than the outcome independent mean of 5.90, 58% conceived compared with only 13% with ratios <5.90 (P < 0.02). CONCLUSION: Higher cortisol:cortisone ratios in conception cycles suggest that active glucocorticoid may be important for final oocyte maturation and embryo implantation in unstimulated cycles.
11ß-hsd, cortisol, cortisone, natural cycle IVF
2410-2414
Keay, S.D.
4fb11caf-e034-4f14-86e5-7b1a9dd76d99
Harlow, C.R.
78ca011c-c7df-47b7-9087-3f25407b51f1
Wood, P.J.
f0dfe718-fa0f-43b1-9b2d-4bdc9c41320a
Jenkins, J.M.
56eb614f-ec2b-4bf5-876e-f2db9907dcd6
Cahill, D.J.
30deeb38-5a6e-410c-a9b3-ca826055896f
Keay, S.D.
4fb11caf-e034-4f14-86e5-7b1a9dd76d99
Harlow, C.R.
78ca011c-c7df-47b7-9087-3f25407b51f1
Wood, P.J.
f0dfe718-fa0f-43b1-9b2d-4bdc9c41320a
Jenkins, J.M.
56eb614f-ec2b-4bf5-876e-f2db9907dcd6
Cahill, D.J.
30deeb38-5a6e-410c-a9b3-ca826055896f

Keay, S.D., Harlow, C.R., Wood, P.J., Jenkins, J.M. and Cahill, D.J. (2002) Higher cortisol:cortisone ratios in the preovulatory follicle of completely unstimulated IVF cycles indicate oocytes with increased pregnancy potential. Human Reproduction, 17 (9), 2410-2414.

Record type: Article

Abstract

BACKGROUND: Conception following gonadotrophin-stimulated IVF and embryo transfer has been associated with a higher intrafollicular cortisol:cortisone ratio and decreased metabolism of cortisol to cortisone. The role of glucocorticoids in human oocyte maturation is not fully understood, but active glucocorticoid (cortisol) may be important. This study relates intrafollicular cortisol and cortisone concentrations to oocyte fertilization and embryo implantation in unstimulated cycles. METHODS: Patients aged <40 years with favourable sperm underwent unstimulated IVF–embryo transfer. Study 1 related intrafollicular cortisol levels to oocyte and IVF outcome: (i) fertilized, pregnant (n = 9); (ii) fertilized, not pregnant (n = 21); and (iii) unfertilized (n = 12). Study 2 was a case–control study of 27 patients (same outcome groups of equal size) which measured intrafollicular cortisol, cortisone and the cortisol:cortisone ratio. RESULTS: Conception cycles demonstrated higher cortisol concentrations compared with the fertilized group (study 1) [median (95% confidence interval): 299 (249–330) versus 227 nmol/l (185–261); P < 0.05] and higher cortisol:cortisone ratios when compared with the unfertilized group (study 2) [7.38 (5.23–9.19) versus 3.56 (1.75–7.46) respectively; P = 0.02]. Of the women with cortisol:cortisone ratios greater than the outcome independent mean of 5.90, 58% conceived compared with only 13% with ratios <5.90 (P < 0.02). CONCLUSION: Higher cortisol:cortisone ratios in conception cycles suggest that active glucocorticoid may be important for final oocyte maturation and embryo implantation in unstimulated cycles.

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More information

Published date: 2002
Keywords: 11ß-hsd, cortisol, cortisone, natural cycle IVF

Identifiers

Local EPrints ID: 24805
URI: http://eprints.soton.ac.uk/id/eprint/24805
PURE UUID: 771f7148-9e5c-4bde-8e72-178891fdaf1f

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Date deposited: 04 Apr 2006
Last modified: 11 Dec 2021 14:53

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Contributors

Author: S.D. Keay
Author: C.R. Harlow
Author: P.J. Wood
Author: J.M. Jenkins
Author: D.J. Cahill

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