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Relationship between midcycle luteinizing hormone surge quality and oocyte fertilization
W M Verpoest1, D J Cahill, C R Harlow
1Centre for Reproductive Medicine, University of Bristol, St Michael's Hospital, Avon, United Kingdom.
Objective:
To determine whether alterations in preovulatory follicular fluid (FF) levels of LH, FSH, and steroids are associated with the probability of fertilization.
Design:
Retrospective analysis of prospective study results.
Setting:
Reproductive medicine clinic of a university teaching hospital.
Patient(S):
Infertile women, with unstimulated, apparently regular cycles in an IVF research program.
Intervention(S):
Measurement of preovulatory FF levels of LH, FSH, E2, and P and serum LH levels by fluoroimmunometry.
Main Outcome Measure:
Oocyte fertilization.
Result(S):
There were 84 transferable embryos (rate of normal fertilization and cleavage, 67%), and 41 oocytes (33%) failed to fertilize. Analysis of the matched FF showed that the median concentration of FF LH was significantly higher for cleaving embryos than for unfertilized oocytes (14.6 vs. 10.4 IU/L). Serum LH concentrations were similarly higher in cycles with cleaving embryos. There were no statistically significant differences in FF concentrations of FSH, E2, or P in the two groups.
Conclusion:
Reduced preovulatory FF LH levels are associated with impaired fertilization of oocytes in vitro, despite normal FF FSH and steroid levels.