The success rate of in vitro fertilization of human oocytes in relation to the concentrations of different hormones in follicular fluid and peripheral plasma.

Seventeen infertile patients were stimulated with clomiphene citrate and human chorionic gonadotrophin (hCG). During laparotomy or laparoscopy, follicles were aspirated. At least one fertilizable oocyte was obtained from 13 patients, who had normal preovulatory plasma 17 beta-estradiol (mean 2.2 nmol/l) in contrast to the 4 patients with infertilizable oocytes (mean 0.4 nmol/l). A close association was found between the success rate of fertilization and the increment of plasma progesterone from the day before to the day after the operation. If the concentrations of 17 beta-estradiol and progesterone in follicular fluid were below an arbitrary limit (17 beta-estradiol less than 500 nmol/l in association with progesterone less than 2,000 nmol/l), no oocytes could be fertilized. Apparently aspiration of oocytes and follicular fluid did not disturb ovarian steroid production during the luteal phase. The results suggest that plasma 17 beta-estradiol and progesterone determinations may serve as useful predictors for oocyte fertilizability in an in vitro system, following clomiphene-hCG stimulation and multiple oocyte recovery.