Does biochemical profile of follicular fluid in women undergoing assisted reproduction vary between the right and left ovaries?

Özkan Özdamar, İsmet Gün, Serkan Satılmış Ertuğrul, Okan Özden, Kenan Sofuoğlu


Background: Follicular fluid (FF) provides a substantial micro-milieu for the development of the oocytes. Moreover, the content of FF may also reflect the circulating biochemical environment and the changes in blood serum. Despite the known embriyological and histological similarities between right and left ovaries, differences do exist between their venous drainage, anatomical relations and cyclical physiological changes. The difference between the two ovaries in the response to controlled hyperstimulatons (COH) in IVF regimens was later confirmed by recent studies. The aim of this study was to compare the biochemical differences between the FFs yielded from the right and left ovaries in patients undergoing standart IVF treatment.

Methods: A prospective observational study was conducted through the unexplained infertility patients with the age between 23-39 years, body mass index (BMI) ≤28 kg/m2, FSH ≤10 mIU/mL. FFs aspirated from the right and the left ovary of the patients were assayed for estradiol, calcium, phosphorus, uric acid, urea, total protein, AST, ALT, glucose, sodium, potassium and creatinine. A total of 10 patients undergoing IVF treatments were included.

Results: The investigated parameters were not significantly different between FFs yielded from the right and left ovaries.

Conclusion: According to the results of our study, biochemical profile of the aspirated FFs does not significantly differ between the right and the left ovary and consequently, either right or left ovaries provide similar micro-environments to the developing oocytes. 


Follicular fluid, Infertility, Right ovary, Left ovary, Biochemistry

Full Text:



Ferraretti AP, Goossens V, Kupka M, Bhattacharya S, de Mouzon J, Castilla JA, et al. European IVF-Monitoring (EIM) Consortium for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 2009: results generated from European registers by ESHRE. Hum Reprod. 2013;28(9):2318-31.

Haggarty P, Wood M, Ferguson E, Hoad G, Srikantharajah A, Milne E, et al. Fatty acid metabolism in human preimplantation embryos. Hum Reprod. 2006;21(3):766–73.

Balaban B, Urman B. Effect of oocyte morphology on embryo development and implantation. Reprod Biomed Online. 2006;12(5):608-15.

Patrizio P, Fragouli E, Bianchi V, Borini A, Wells D. Molecular methods for selection of the ideal oocyte. Reprod Biomed Online. 2007;15:346-53.

Dawson A, Griesinger G, Diedrich K. Screening oocytes by polar body biopsy. Reprod Biomed Online. 2006;13(1):104-9.

Revelli A, Delle Piane L, Casano S, Molinari E, Massobrio M, Rinaudo P. Follicular fluid content and oocyte quality: from single biochemical markers to metabolomics.Reprod Biol Endocrinol. 2009;7:40.

Wu YT, Tang L, Cai J, Lu XE, Xu J, Zhu XM, et al. High bone morphogenic protein-15 level in follicular fluid is associated with high quality oocyte and subsequent embryonic development. Hum Reprod. 2007;22:1526–31.

Berker B, Kaya C, Aytac R, Satiroglu H. Homocysteine concentrations in follicular fluid are associated with poor oocyte and embryo qualities in polycystic ovary syndrome patients undergoing assisted reproduction. Hum Reprod. 2009;24(9):2293–302.

Piñero-Sagredo E, Nunes S, de los Santos MJ, Celda B, Esteve V. NMR metabolic profile of human follicular fluid. NMR Biomed. 2010;23:485–95.

Wallace M, Cottell E, Gibney MJ, McAuliffe FM, Wingfield M, Brennan L. An investigation into the relationship between the metabolic profile of follicular fluid, oocyte developmental potential, and implantation outcome. Fertil Steril. 2012;97:1078–84.

Leroy JL, Vanholder T, Delanghe JR, Opsomer G, Van Soom A, Bols PE, et al. Metabolic changes in follicular fluid of the dominant follicle in high-yielding dairy cows early post-partum. Theriogenology 2004;62(6):1131-43.

Thomson AJ, Gazvani MR, Wood SJ, Meacock SC, Lewis-Jones DI, Kingsland CR. Comparison of ovarian response in right and left ovaries in IVF patients. Hum Reprod. 2001;16(8):1694-7.

Fukuda M, Fukuda K, Andersen CY, Byskov AG. Right-sided ovulation favours pregnancy more than left-sided ovulation. Hum Reprod. 2000;15(9):1921-6.

Lan KC, Huang FJ, Lin YC, Kung FT, Lan TH, Chang SY. Significantly superior response in the right ovary compared with the left ovary after stimulation with follicle-stimulating hormone in a pituitary down-regulation regimen. Fertil Steril. 2010;93(7):2269-73.

Potashnik G, Insler V, Meizler I. Frequency, sequence and side of ovulation in women menstruating normally. Br Med J (Clin Res Ed). 1987;294(6566):219.

Jungheim ES, Macones GA, Odem RR, Patterson BW, Lanzendorf SE, Ratts VS, et al. Associations between free fatty acids, cumulus oocyte complex morphology and ovarian function in vitro fertilization. Fertil Steril. 2011;95(6):1970–4.

Robker RL, Akison LK, Bennett BD, Thrupp PN, Chura LR, Russell DL, et al. Obese women exhibit differences in ovarian metabolites, hormones and gene expression compared to moderate weight women. J Clin Endocrinol Metab. 2009; 94:1533–40.

Yang X, Wu LL, Chura LR, Liang X, Lane M, Norman RJ, et al. Exposure to lipid-rich follicular fluid is associated with endoplasmic reticulum stress and impaired oocyte maturation in cumulus–oocyte complexes. Fertil Steril. 2012;97(6):1438–43.

O'Gorman A, Wallace M, Cottell E, Gibney MJ, McAuliffe FM, Wingfield M, et al. Metabolic profiling of human follicular fluid identifies potential biomarkers of oocyte developmental competence. Reproduction. 2013;146(4):389-95.

Schweigert FJ, Gericke B, Wolfram W, Kaisers U, Dudenhausen JW. Peptide and protein profiles in serum and follicular fluid of women undergoing IVF. Hum Reprod. 2006;21:2960-8.

D'Aniello G, Grieco N, Di Filippo MA, Cappiello F, Topo E, D'Aniello E, et al. Reproductive implication of D-aspartic acid in human pre-ovulatory follicular fluid. Hum Reprod. 2007;22:3178-83.

Józwik M, Józwik M, Teng C, Battaglia FC. Amino acid, ammonia and urea concentrations in human pre-ovulatory ovarian follicular fluid. Hum Reprod. 2006;21(11):2776-82.