[Role of follicular fluid analysis in assessment of the main criteria of folliculogenesis in IVF program].

A comparative study was carried out to assess the main criteria of folliculogenesis in follicular fluid of aspirated follicles during the induction of super ovarian stimulation using recombinant follicle stimulating hormone (r-FSH; Gonal-F), human menopausal gonadotropin (HMG, Pergonale) and agonist gonadotropin releasing hormone (a-GnRH; Diphereline 3,75 mg). 86 patients were included in the study: 37 were receiving r-FSH and 49 HMG, two ampoules per day during the first 5 days of stimulation. Ultrasound monitoring was used for every individual follicle on the first day of stimulation and starting from the 5th day, daily. Thus, the visualized follicles were identified and measured, photoregistered during the whole period of ultrasound guidance. During the transvaginal puncture of these follicles the aspirated follicular fluid volume, existence of oocytes, and its estradiol hormones were recorded. It was found that the follicles in both groups of patients having larger volume of follicular fluid (3 to 5 or >5mm) reached the preovulational size earlier (diameter 17 mm), and on the day of injection of human chorionic gonadotropin (HCG; 10000 IU) had a large size (20 to 21 mm). The positive statistically significant correlation has been observed between the volume of follicular fluid and existence of oocytes in aspirated follicular fluid, as well as with the intensity of their cleavage. The concentration of testosterone and estradiol in follicular fluid was lower in the patients receiving r-FSH (average 12.4 nmol/l, range 9.3-15.1 and 1897113 pmol/l; range 1609216-2185012) than in the patients receiving HCG (16.0 nmol/l; range 12.1-19.6 and 2233728 pmpl/l; range 2028660-2438718). The concentration of testosterone in non-pregnant patients receiving r-FSH was 13.7-/+1.0 nmol/l, receiving HMG - 16.0-/+0.9 nmol/l, versus 10.3-/+0.8 nmol/l and 14.8-/+0.7 nmol/l, in the patients receiving r-FSH and HMG, respectively, who became pregnant. Thus, the comparative study of main criteria of folliculogenesis in follicular fluid proved to be more preferable and sufficient using FSH in the ovarian stimulation protocol in IVF program.