Objective: To find out if there is some amount of fructose in the follicular fluid of IVF stimulated patients. If so then to compare fructose and glucose levels with IVF outcome, type of stimulation and infertility factors.
Design: Retrospective study.
Setting: Department of Gynaecology and Obstetrics, Charles University, the Czech Republic.
Methods: 202 women undergoing IVF treatment since 11/1999 till 02/2001 were evaluated. We measured a level of fructose and glucose in a sample of serum and follicular fluid (FF) obtained at ovum pick-up. Then the results were compared with the IVF outcome, the length of stimulation and infertility factors. The control group consists of 23 women with a pure andrologic factor of infertility.
Results: At the day of pick-up the serum concentration of glucose and fructose taken on an empty stomach is on average 5.43 +/- 1.35 mmol/l and 25.05 +/- 9.26 micrograms/ml compared to 5.26 +/- 1.00 mmol/l and 23.69 +/- micrograms/ml in control group. The concentration of both glucose and fructose in FF correlates with their serum level. The FF concentration of glucose is on average 3.75 +/- 1.32 mmol/l (70% of serum concentration) and fructose 11.34 +/- 5.29 micrograms/ml (48% of serum concentration) by comparison with 3.78 +/- 0.91 mmol/l (73%) and 12.37 +/- 7.06 micrograms/ml (53%) in control group.
Conclusion: There is a possible influence of follicular fluid saccharides like glucose and fructose in process of fertilization. We derived this hypothesis from studies evaluating the role of saccharides in endometrial secretion, cervical mucous and seminal plasma. We assumed that patients with a successful IVF cycle have a lower fructose concentration in FF. The clinical pregnancy is really mildly lower but this difference is not statistically significant. We confirmed FF fructose is in close correlation with its serum concentration. But we did not confirm the FF glucose and FF fructose concentration is related to the IVF outcome.