BACKGROUND Human follicular fluid is an intricate biological fluid contributing to the developing oocyte microenvironment. Accumulating evidence suggests that sex hormones present in follicular fluid (FF) may play an important role in regulating oocyte developmental potential. The aim of this study was to determine if anti-Müllerian hormone (AMH) and progesterone (P4) levels in FF are correlated with oocyte quality as defined by subsequent embryonic development. METHODS This was a prospective cohort study of 88 women undergoing IVF/ICSI at a university associated fertility clinic. Follicular fluid was collected from the first follicle aspirated at the time of oocyte retrieval. The corresponding oocyte was individually cultured in order to track its developmental outcome. FF-AMH and P4 concentrations from follicles where the oocyte fertilised normally and developed into a blastocyst on day 5 (Group 1: BLAST, n = 23) were compared with FF from follicles where the oocyte fertilised normally but failed to reach blastocyst stage by day 5 (Group 2: FERT, n = 19). No significant differences were observed between the two groups in terms of maternal age, body mass index, previous live births, previous pregnancy loss, number of antral follicles, number of oocytes recovered, IVF:ICSI ratio or percentage of recovered oocytes that fertilised. RESULTS FF-AMH and P4 levels were significantly increased in Group 1: BLAST compared to Group 2: FERT (P = 0.007 and P = 0.013 respectively). Twenty-one FF samples had an AMH level > 15 pmol/L, of which 17 related to oocytes that progressed to blastocyst stage, providing a positive prediction value (PPV) of 76.96%. Eleven FF samples had a P4 level > 60 mg/ml, of which 10 progressed to blastocyst stage, providing a PPV of 90.99%. Six samples had an AMH level > 15 pmol/L and a P4 level > 60 mg/ml, of which 100% progressed to blastocyst stage, providing a PPV of 96.83%. CONCLUSIONS FF-AMH and P4 levels from individual follicles can accurately predetermine subsequent embryonic development. Combining follicular fluid analysis with routine morphological assessment, could allow for a more accurate and sensitive method of determining embryonic developmental competence.

中文翻译：

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人卵泡液中的抗苗勒管激素和孕酮水平是胚胎发育的预测因子。

背景技术人卵泡液是有助于发育的卵母细胞微环境的复杂的生物液。越来越多的证据表明，卵泡液（FF）中存在的性激素可能在调节卵母细胞的发育潜力中起重要作用。这项研究的目的是确定FF中的抗苗勒氏激素（AMH）和孕酮（P4）水平是否与后续胚胎发育所定义的卵母细胞质量相关。方法这是一项前瞻性队列研究，研究对象是88位在大学附属生育诊所接受IVF / ICSI治疗的妇女。从卵母细胞取出时吸出的第一个卵泡中收集卵泡液。单独培养相应的卵母细胞以追踪其发育结果。将卵母细胞正常受精并在第5天发育为囊胚的卵泡中FF-AMH和P4的浓度（第1组：BLAST，n = 23）与卵母细胞正常受精但未能达到胚泡阶段的卵泡中的FF进行比较。 5（组2：FERT，n = 19）。两组之间在产妇年龄，体重指数，以前的活产，以前的怀孕流失，肛门卵泡的数量，卵母细胞的回收率，IVF：ICSI比率或受精卵子的回收率方面均未观察到显着差异。结果与组2：FERT相比，组1：BLAST的FF-AMH和P4水平显着增加（分别为P = 0.007和P = 0.013）。21个FF样品的AMH水平> 15 pmol / L，其中17个与卵母细胞发展为胚泡期有关，提供了76.96％的正预测值（PPV）。11个FF样品的P4水平> 60 mg / ml，其中10个进入囊胚期，PPV为90.99％。六个样品的AMH水平> 15 pmol / L，P4水平> 60 mg / ml，其中100％进入胚泡期，PPV为96.83％。结论来自单个卵泡的FF-AMH和P4水平可以准确地预先确定随后的胚胎发育。卵泡液分析与常规形态学评估相结合，可以为确定胚胎发育能力提供更准确，更灵敏的方法。其中100％进入了胚泡期，PPV为96.83％。结论来自单个卵泡的FF-AMH和P4水平可以准确地预先确定随后的胚胎发育。卵泡液分析与常规形态学评估相结合，可以为确定胚胎发育能力提供更准确，更灵敏的方法。其中100％进入了胚泡期，PPV为96.83％。结论来自单个卵泡的FF-AMH和P4水平可以准确地预先确定随后的胚胎发育。卵泡液分析与常规形态学评估相结合，可以为确定胚胎发育能力提供更准确，更灵敏的方法。