Follicular steroids as a prognosticator of successful fertilization of human oocytes in vitro.

Oocytes were collected by aspiration of preovulatory follicles from 55 women. The preovulatory rise in LH was monitored in urine using the Hi-Gonavis (Mochida Pharmaceuticals) technique. Patients were treated either during the natural cycle or after the induction of ovulation with clomiphene citrate. After collection and culture, the oocytes were inseminated with the spermatozoa of the husband. The levels of progesterone, oestradiol-17 beta and androstenedione in the clear follicular fluid were measured by radioimmunoassay. A multivariate analysis containing these three hormone levels together with two ratios of progesterone with each of the other hormones indicated reasonable discrimination between the oocytes which fertilized and those which remained unfertilized after insemination. The discriminant analysis suggested that the fertilization of the oocytes could have been predicted on the basis of these hormonal profiles with a success rate which exceeded 90%.