Hormonal microenvironment of the follicle as a predictor of oocyte nuclear maturity and normal fertilization in IVF/ICSI cycles: A prospective observational study
DOI:
https://doi.org/10.37800/RM.1.2026.681Keywords:
follicular fluid, oocyte, metaphase II, 2PN, hormonal microenvironment, IVF/ICSIAbstract
Relevance: Follicular fluid is a localized, hormonally active environment in which the oocyte’s biological readiness for the completion of meiosis and normal fertilization is established during in vitro fertilization with intracytoplasmic sperm injection (IVF/ICSI) cycles. Unlike systemic hormonal levels, the hormonal composition of follicular fluid reflects local regulatory processes within the follicle.
This study aimed to identify the association between the local hormonal profile of follicular fluid and oocyte nuclear maturity, as well as normal fertilization, in IVF/ICSI cycles in women of reproductive age.
Materials and Methods: A prospective observational analytical study was conducted, including 60 IVF/ICSI cycles in 60 women. Follicular fluid was collected by transvaginal follicular puncture before follicular lavage. Concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) in the follicular fluid were determined using an electrochemiluminescence assay. Oocyte nuclear maturity was assessed by reaching metaphase II (MII), and normal fertilization was determined by the formation of zygotes with two pronuclei (2PN). Hormonal balance was analyzed using index hormone ratios. Statistical analysis was performed using IBM SPSS Statistics 26.0.
Results: It was established that the hormonal profile of follicular fluid is associated with oocyte nuclear maturity and the formation of normally fertilized 2PN zygotes. The most informative parameters of the local hormonal microenvironment were LH levels and the FSH/E2 index ratio, while isolated FSH levels at the puncture stage did not demonstrate a significant association with embryological outcomes.
Conclusions: Analysis of the hormonal composition of follicular fluid allows for the identification of local endocrine regulatory loops associated with the completion of oocyte nuclear maturation and normal fertilization in IVF/ICSI cycles. This can be used as an additional component in the comprehensive assessment of oocyte biological maturity.
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