Assessment of the follicular cortisol:cortisone ratio.

Cortisol and cortisone concentrations in serum and follicular fluid (FF) from women undergoing in-vitro fertilization (IVF) treatment were monitored. Four groups were included: group 1, women in their natural menstrual cycle having an endogenous mid-cycle surge of gonadotrophins; group 2, women in their natural menstrual cycle receiving human chorionic gonadotrophin (HCG) for ovulation induction; group 3, women receiving exogenous gonadotrophins for ovarian stimulation and HCG for ovulation induction; and group 4, women receiving exogenous gonadotrophins for ovarian stimulation, follicles being aspirated immediately before administration of HCG. In this study, 12 follicles contained oocytes which resulted in clinical pregnancy after IVF. Cortisone concentrations were significantly higher in FF compared with that of matched serum samples, while the opposite was observed for cortisol, resulting in cortisol:cortisone ratios being significantly lower in FF compared with serum. FF from group 4 showed significantly higher cortisone concentrations than FF from each of the other three groups. FF from group 1 showed significantly higher cortisone concentrations and significantly lower cortisol:cortisone ratios in comparison with groups 2 and 3. None of the observed parameters pinpointed any of the follicles containing oocytes which resulted in a clinical pregnancy. The intrafollicular concentrations of cortisol and cortisone suggest that pre-ovulatory follicles actively convert cortisol to cortisone. Neither FF concentrations of cortisol and cortisone nor the cortisol:cortisone ratio seem to reflect implantation potential of the derived pre-embryos.

[1]  D. Lamb,et al.  World Health Organization Laboratory Manual for the Examination of Human Semen and Sperm‐Cervical Mucus Interaction, 4th ed. , 2000, Journal of Andrology.

[2]  Mason,et al.  Corticosteroid metabolism in human granulosa‐lutein cells , 1998, Clinical endocrinology.

[3]  J. Levron,et al.  Cortisol concentrations in follicular fluid of 'low responder' patients. , 1998, Human reproduction.

[4]  P. Stewart,et al.  Isoforms of 11β-hydroxysteroid dehydrogenase in human granulosa-lutein cells , 1997, Molecular and Cellular Endocrinology.

[5]  J. Fiet,et al.  Radioimmunoassay of cortisone in serum, urine, and saliva to assess the status of the cortisol-cortisone shuttle. , 1997, Clinical chemistry.

[6]  R. Winston,et al.  Increased follicular fluid total and free cortisol levels during the luteinizing hormone surge. , 1997, Fertility and sterility.

[7]  R. Anderson,et al.  Differential expression of messenger ribonucleic acids encoding 11beta-hydroxysteroid dehydrogenase types 1 and 2 in human granulosa cells. , 1997, The Journal of clinical endocrinology and metabolism.

[8]  M. Hull,et al.  Stress and stress-related hormones during in-vitro fertilization treatment. , 1996, Human reproduction.

[9]  R. Shaw,et al.  Ovarian 11β-hydroxysteroid dehydrogenase activity is inversely related to the outcome of in vitro fertilization-embryo transfer treatment cycles*† , 1995 .

[10]  R. Shaw,et al.  Ovarian 11 beta-hydroxysteroid dehydrogenase activity is inversely related to the outcome of in vitro fertilization-embryo transfer treatment cycles. , 1995, Fertility and sterility.

[11]  R. Kimmig,et al.  Variations of steroid hormone metabolites in serum and urine in polycystic ovary syndrome after nafarelin stimulation: evidence for an altered corticoid excretion. , 1995, The Journal of clinical endocrinology and metabolism.

[12]  C. Andersen,et al.  Intrafollicular concentrations of free cortisol close to follicular rupture. , 1994, Human reproduction.

[13]  Stewart Pm,et al.  Hyperandrogenism in polycystic ovary syndrome. , 1994, The New England journal of medicine.

[14]  B. Cooke,et al.  A working hypothesis for the regulation of steroidogenesis and germ cell development in the gonads by glucocorticoids and 11β-hydroxysteroid dehydrogenase (11βHSD) , 1994, Molecular and Cellular Endocrinology.

[15]  R. Clayton,et al.  Hyperandrogenism in polycystic ovary syndrome. Evidence of dysregulation of 11 beta-hydroxysteroid dehydrogenase. , 1994, The New England journal of medicine.

[16]  L. Espey.  Current status of the hypothesis that mammalian ovulation is comparable to an inflammatory reaction. , 1994, Biology of reproduction.

[17]  C. Edwards,et al.  Hyperandrogenism in polycystic ovary syndrome. , 1994, The New England journal of medicine.

[18]  C. Edwards,et al.  Ovarian 11β-hydroxysteroid dehydrogenase: potential predictor of conception by in-vitro fertilisation and embryo transfer , 1993, The Lancet.

[19]  P. Curtis,et al.  Direct inhibition of ovarian steroidogenesis by Cortisol and the modulatory role of 11β‐hydroxysteroid dehydrogenase , 1993, Clinical endocrinology.

[20]  W. Mercer,et al.  Characterization of 11β-HSD1B gene expression and enzymatic activity , 1993, Molecular and Cellular Endocrinology.

[21]  R. Benediktsson,et al.  11 beta-Hydroxysteroid dehydrogenase in the rat ovary: high expression in the oocyte. , 1992, The Journal of endocrinology.

[22]  L. Westergaard,et al.  Human preovulatory follicular fluid: inhibin and free steroids related to optimal follicular maturation in ovarian stimulation regimes and possible function in ovulation. , 1992, Human reproduction.

[23]  C. Invitti,et al.  Increased urinary free cortisol and decreased serum corticosteroid-binding globulin in polycystic ovary syndrome. , 1991, Acta endocrinologica.

[24]  H. J. Ingerslev.  Selective follicular reduction following ovulation induction by exogenous gonadotrophins in polycystic ovarian disease. A new approach to treatment. , 1991, Human reproduction.

[25]  L. Dehennin.  Cortisol determination in follicular fluid. , 1990, Fertility and sterility.

[26]  R. Edwards,et al.  Short-term luteinizing hormone-releasing hormone agonist treatment: prospective trial of a novel ovarian stimulation regimen for in vitro fertilization. , 1989, Fertility and sterility.

[27]  Z. Ben-Rafael,et al.  Cortisol levels in human follicular fluid. , 1989, Fertility and sterility.

[28]  C. Monder,et al.  Evidence for kinetically distinct forms of corticosteroid 11 beta-dehydrogenase in rat liver microsomes. , 1989, Journal of steroid biochemistry.

[29]  V Schiøler,et al.  Six direct radioimmunoassays of estradiol evaluated. , 1988, Clinical chemistry.

[30]  J. D. Neill,et al.  The Physiology of reproduction , 1988 .

[31]  J Scott-Wilson,et al.  Book Review: Laboratory Manual for the Examination of Human Semen and Semen-Cervical Mucus Interaction , 1982, Journal of the Royal Society of Medicine.