Ahmed Ebbiary N A, Lenton E A, Welsby R, Mowforth A, Cooke I D
Academic Department of Obstetrics and Gynaecology, University of Sheffield, UK.
Hum Reprod. 1995 Sep;10(9):2325-33. doi: 10.1093/oxfordjournals.humrep.a136294.
During development of the dominant follicle, the avascular granulosa cells and oocyte are exposed to the follicular fluid endocrine microenvironment. An alteration in the endocrine characteristics of follicular fluid affects follicular steroidogenesis, oocyte maturation, ovulation and subsequent corpus luteum function. In-vitro studies on pooled follicular fluid from ovarian specimens lacked temporal precision between menstrual and follicular endocrine events. We have established a new technique, termed folliculocentesis (FC), to sample follicular fluid from the dominant ovarian follicle without compromising its growth or function during the mid- to late follicular phase. A total of 38 subjects with regular ovulatory cycles each underwent two identical cycles of hormone and follicle growth monitoring: one cycle served as the control, and FC was performed during the second cycle. During all cycles, plasma luteinizing hormone (LH), oestradiol and ultrasound monitoring of follicle growth were commenced on day 7 and continued until after ovulation. During FC cycles, 200 microliters of follicular fluid were aspirated from the dominant follicle using transvaginal ultrasound guidance when the follicle diameter reached > or = 10 mm. Six subjects were excluded from the study because of incomplete or invalid endocrine data. In all, 32 subjects completed both the FC and control cycles. The follicle growth pattern, maximum follicle diameter, plasma oestradiol, oestradiol peak, plasma LH, LH surge and follicular phase length were similar during FC and control cycles. A total of 50 valid follicular fluid samples were obtained when the dominant follicle was sampled once, twice or three times during the same cycle and from the same follicle in 15, 16 and one subjects respectively. The follicular fluid samples contained steroid concentrations consistent with those of the mid- to late follicular phase. We conclude that the FC procedure is safe, easy to perform and does not affect follicle growth or hormone dynamics. Analysis of the follicular fluid samples is expected to provide us with valuable in-vivo information about ovarian endocrinology.
在优势卵泡发育过程中，无血管的颗粒细胞和卵母细胞暴露于卵泡液内分泌微环境中。卵泡液内分泌特征的改变会影响卵泡类固醇生成、卵母细胞成熟、排卵及随后的黄体功能。对来自卵巢标本的混合卵泡液进行的体外研究缺乏月经和卵泡内分泌事件之间的时间精确性。我们建立了一种新技术，称为卵泡穿刺术（FC），用于在卵泡期中期至晚期从优势卵巢卵泡中采集卵泡液，而不影响其生长或功能。共有38名排卵周期规律的受试者各自经历了两个相同的激素和卵泡生长监测周期：一个周期作为对照，在第二个周期进行卵泡穿刺术。在所有周期中，于第7天开始监测血浆促黄体生成素（LH）、雌二醇以及通过超声监测卵泡生长，持续至排卵后。在卵泡穿刺术周期中，当卵泡直径达到≥10 mm时，使用经阴道超声引导从优势卵泡中抽吸200微升卵泡液。6名受试者因内分泌数据不完整或无效而被排除在研究之外。总共32名受试者完成了卵泡穿刺术和对照周期。卵泡穿刺术周期和对照周期的卵泡生长模式、最大卵泡直径、血浆雌二醇、雌二醇峰值、血浆LH、LH峰及卵泡期长度相似。当在同一周期对同一卵泡进行一次、两次或三次采样时，分别在15名、16名和1名受试者中获得了总共50份有效的卵泡液样本。这些卵泡液样本中的类固醇浓度与卵泡期中期至晚期的浓度一致。我们得出结论，卵泡穿刺术操作安全、易于实施，且不影响卵泡生长或激素动态变化。对卵泡液样本的分析有望为我们提供有关卵巢内分泌学的宝贵体内信息。
