Follicular fluid prostaglandin E2:prostaglandin F2 alpha ratio in relation to outcome of matched oocyte.

The prostaglandins PGE2 and PGF2 alpha and the steroid hormones oestradiol (E2) and progesterone (P) were measured in 345 follicular fluids of patients undergoing ovarian hyperstimulation for in-vitro fertilization (IVF). The measured concentrations were analysed in relation to the outcome of the matched oocyte. Progesterone levels were significantly lower in the unfertilized group (P less than 0.005) compared to the fertilized group but there was no difference between 'pregnancy' and 'no pregnancy'. No differences were shown in either E2 levels or the E2:P ratio. No significant differences were shown among the groups in the concentration of either PGE2 or PGF2 alpha but there were highly significant differences shown when the PGE2:PGF2 alpha ratios were compared. The PGE2:PGF2 alpha ratio fell within a much narrower range for the 'pregnancy' group compared with any of the other groups. The ratio was significantly lower (P less than 0.001) when 'pregnancy' was compared with 'no pregnancy'. The range of the prostaglandin ratio found for the 'pregnancy' group may reflect the moment when conditions are optimal within the follicle for the associated oocyte to go on to establish pregnancy.