Impact of estradiol and homocysteine concentrations from follicular fluid and peripheral blood on the outcome of assisted reproduction treatment

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 561-585-Ovarian & Uterine Function II
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-576
Aline Amaro Santos1, Bianca Bianco2, Juliana Christofolini1, Fernanda Abani Mafra1, Denise Christofolini*1 and Caio Parente Barbosa1
1Faculdade de Medicina do ABC, Santo Andre, Brazil, 2Faculdade de Medicina do ABC, Sao Paulo, Brazil
Introduction: The oocyte is inserted in a microenvironment with metabolites that have extreme importance for its development. Functionally in a cycle, estrogens are responsible for oocyte maturation, fertilization, embryo development and helps maintain the pregnancy. Homocysteine is a product of the folate metabolism linked to important physiological processes as impaired cell division, production of inflammatory cytokine and high rates of apoptosis. Thus, decreased or increased levels of homocysteine and estrogens in the serum or in the follicular fluid could be related to infertility and associated to assisted reproduction techniques (ART) outcomes.

Objective: The aim of this study is to correlate serum and follicular levels of estradiol and homocysteine in infertile women with results of assisted reproduction.

Patients and methods: The studied groups comprised 29 women with idiopathic infertility (GI) and 44 patients with endometriosis (GII). A control group (GIII) was composed by 35 fertile women whose partner presents male infertility. All women underwent ART at Faculdade de Medicina do ABC, Brazil. The analysis of serum and follicular fluid was performed by measuring the concentrations of estradiol and homocysteine. Statistical analyses was done by Person’s correlation and considered significant when p<0.005.

Results: In GI group the serum and follicular estradiol levels were positively correlated with the number of follicles observed by US (p=0.0001; p=0.0011), oocytes retrieved (p=0.0001; p=0.0006), oocyte maturation (p=0.0006; p=0.0013), fertilization rates (p=0.0212; 0.0267) and number of embryos for transfer (p=0.0036; p=0.0078). For GII group the estradiol serum levels were only correlated with oocyte maturation (p=0.0331). Considering GIII we observed a positive correlation serum levels of estradiol with the number of follicles observed by US (p=0.0001), oocytes retrieved (p=0.0001) and oocyte maturation (p=0.0008). Fertilization rates and embryos for transfer were not evaluated in GIII. Regarding homocysteine levels, serum and follicular, we did not observe difference in the parameters evaluated.

Conclusion: We observed that higher estradiol levels, better the embryonic parameters. Except for endometriosis, an estrogens dependent disease with high circulating levels of these hormones, the serum levels of estradiol are sufficient to determine this correlation.

Nothing to Disclose: AAS, BB, JC, FAM, DC, CPB

*Please take note of The Endocrine Society's News Embargo Policy at

Sources of Research Support: Financial Support: FAPESP (Fundação de Amparo a Pesquisa do Estado de São Paulo) no. 2010/16274-4 and CNPq no. 476116/2010-4