[Pregnancies by fertilization in vitro. Biochemistry of the follicular fluid]. / Grossesses par fécondation in vitro. Biochimie du liquide folliculaire.

Fifty four follicular fluids containing 41 oocytes were sampled from 6 patients in which at least one pregnancy was obtained after IVF. Their biochemical composition has been correlated with the follicle maturity and oocyte quality. Three components have been assayed: steroids, prostanoids, proteolytic enzymes. Determinations of estrogens and total aromatisable androgens were carried out by the enzymatic technic of Nicolas and al.; progesterone and 17 OH progesterone by RIA. Development of in vitro cultured and fertilized oocytes appears to be improved when progesterone and estrogens concentrations in the follicular fluid are above 2 000 and 600 ng/ml respectively, with an A/E ratio under 1. On the other hand, prostanoids (T X B2, PGE2, PGF2 alpha determined by RIA) and proteolytic enzymes : (collagenolytic and kallikrein type activities) seemed related to ovulatory activity rather than to oocyte quality.

[Predicting ovulation by detecting the preovulatory rise of estrogens and LH in the urine]. / Prédiction de l'ovulation par détection de l'ascension préovulatoire des oestrogènes et de la LH dans les urines.

The preovulatory LH surge induces final maturation of the ovocyte which makes it suitable for in vitro fertilization. The spontaneous LH peak can be detected in blood or in the urine. Whatever the method of determination, the diagnosis of the triggering LH surge can be done only on strict criteria. This work defines these criteria when urinary Higonavis is used: a rise in the plus signs in two successive samples or a positive result in urine diluted fourfold.

[Collection of mature ovocytes during cycles with spontaneous ovulation for the purpose of in vitro fertilization]. / Recueil d'ovocytes mûrs au cours de cycles à ovulation spontanée en vue de fécondation in vitro.

In vitro fertilization was attempted during a spontaneous cycle in 17 out of 97 patients. Preovulatory urinary estrogen and LH maximas were assayed in order to time celioscopy 24 hours after the onset of the triggering urinary LH maxima. In 8 patients, comparison with plasmatic LH shows that the timing of spontaneous ovulation can be precisely predicted from urine assays. However, when the triggering LH release is weak, LH must be above or equal to 25 IU/g of creatinine with a creatininuria above or equal to 0.4 g/l in two urine samples at a three-hour interval.