Endocrine Abstracts

Introduction: Biochemical follow up of the ovarian function after ovarian stimulation is restricted to the measurement of serum oestradiol and progesterone. We aim to investigate the entire ovarian steroidognesis after ovarian stimulation.

Materials and methods: 50 women (26 IVF and 24 ICSI) who underwent AMP induction (based on rFSH stimulation after GnRH agonist or antagonist) for the same cause of infertility were retrospectively involved and compared to 11 IUI (control). Oestrogens (oestrone, oestradiol, and oestriol), androgens (Δ4-androstenedione and testosterone), and progestatives (progesterone and 17 hydroxyprogesterone) were measured using immunoassay (RIA and CobasR Roche) each 48 h (days 5–13 in AMP and days 8–14 in control). Steroid profiles were characterized using mass spectrometry. Results are expressed as median values and a P<0.05 was considered significant.

Results: Steroids basal secretion was within the normal range (IVF, ICSI, and IUI respectively): oestradiol (223, 317.5, and 314 pmol/l), testosterone (1124.5, 903.5, and 1606.5 pmol/l), Δ4-androstenedione (3902, 3100, and 5618 pmol/l), 17 hydroxyprogesterone (1186, 1350, and 2397.5 pmol/l), and progesterone (1150, 1150, and 2950 pmol/l). We observed a significant increase in oestradiol (4638, 7864.5, and 1282 pmol/l) and Δ4-androstenedione (5932, 11 850, and 7477 pmol/l) (IVF, ICSI, and IUI respectively). The 48 h increase was significantly different between control and AMP for estradiol (1.5-fold for IIU, 1.8-fold for IVF, and 1.9-fold for ICSI) and Δ4-androstenedione (1.02-fold for IIU and 1.31-fold for ICSI). Testosterone, hydroxyprogesterone, and progesterone increase significantly only in the induced group, i.e. 1702.5 and 1470 pmol/l; 12 344 and 8650 pmol/l; and 2450 and 4150 pmol/l for IVF and ICSI respectively. There was no difference in the 48 h increase of those steroids between ICSI and FIV except for Δ4-androstenedione which increased (1.15-fold for FIV and 1.31-fold for ICSI).

Conclusion: rFSH treatment in AMP is likely to induce a biochemical ovarian hyperplasia. However, we have highlighted individual variations, which we are exploring by mass spectrometry.