Follicular development during the luteal phase of the human menstrual cycle

The aims of the present studies were to determine the number, size range, health, and steroidogenic activities of antral follicles in normal human ovaries during the luteal phase of the menstrual cycle. Steroidogenic activity was assessed from the levels of androstenedione, testosterone, and estradiol in follicular fluid and the levels of extant and FSH-stimulable aromatase activity and FSH-stimulable progestin synthesis in the granulosa cells. Data for luteal phase ovaries were compared to those obtained for ovaries from the late follicular phase. On average, 94% (range, 70-100%) of the luteal phase follicles (greater than or equal to 1 mm diameter) were atretic as assessed by oocyte viability and granulosa cell number. The largest healthy follicles during the mid- to late luteal phase were 4-4.5 mm in diameter; these contained high levels of aromatizable androgen (500-2000 ng/ml), low levels of estradiol (less than 10 ng/ml), and granulosa cells with an extant level of aromatase activity 200 times lower than that in a preovulatory follicle. Based on these biochemical criteria, healthy (luteal phase) follicles were not distinguishable from atretic follicles. Granulosa cells from the luteal phase follicles were responsive to FSH with respect to progesterone and estradiol biosynthetic activity; the aromatase system in the cells from the mid- to late luteal phase follicles was significantly more responsive to FSH than that in cells from late follicular or early luteal phase follicles (P less than 0.05). These data suggest that the number of healthy luteal phase follicles (greater than or equal to 1 mm diameter) available for subsequent preovulatory development is limited.