Relationship between follicular fluid hormone levels, embryo quality, and maternal age during in vitro fertilization after the short or long protocol with a gonadotropin releasing hormone agonist

Purpose: To examine the relationship between embryo quality and follicular fluid hormonal level in short and long protocol gonadotrophin releasing hormone agonist treatment cycles. Methods: A total of 90 patients had non-polycystic ovary syndrome (non-PCOS) and 10 had PCOS. A total of 100 subjects underwent in vitro fertilization (IVF). Thirty-six subjects underwent conventional IVF and 64 subjects underwent intracytoplasmic sperm injection (ICSI). The dominant follicles were initially retrieved and a hormonal assay was done. A total of 32 patients underwent a short protocol and 66 patients were treated with the long protocol. Estradiol (E2), progesterone (P4), total testosterone (TTE) and androstenedione (ASG) levels in follicular fluid (FF) were compared in the two treatment groups (short and long protocol), in regard to maternal age and oocyte/embryo quality. Results: The retrieval FF volume was not significantly different between the PCOS and non-PCOS patients; however, P4 was significantly lower with PCOS (P < 0.01). Analysis of four different hormone levels was not significantly different between the short and long protocol groups. No significant relationship was found between four hormone levels in regard to oocyte morphology and embryo quality. The levels of P4 of younger women was significantly lower than that of older women; furthermore, a significantly higher TTE and ASG were found in the younger women. Progesterone was found to statistically significantly increase with FF volume. Conclusion: Follicular fluid P4 from the younger group was significantly lower, and TTE and ASG was significantly higher when compared to the older group. Analysis of four different hormone levels revealed no significant difference between the short and long protocol groups. No significant relationship was found between four hormone levels, oocyte morphology, and embryo quality. (Reprod Med Biol 2003; 2: 165-169).