Intrafollicular cortisol levels inversely correlate with cumulus cell lipid content as a possible energy source during oocyte meiotic resumption in women undergoing ovarian stimulation for in vitro fertilization

We discuss how follicular fluid cortisol levels may regulate cumulus cell lipolysis during oocyte meiotic resumption and affect oocyte quality during in vitro fertilization.

Ariel A. Simerman, B.A., David L. Hill, Ph.D., Tristan R. Grogan, M.S., David Elashoff, Ph.D., Nigel J. Clarke, Ph.D., Ellen H. Goldstein, M.D., Alexa N. Manrriquez, B.S., Gregorio D. Chazenbalk, Ph.D., Daniel A. Dumesic, M.D.

Volume 103, Issue 1, Pages 249-257


To determine whether follicular fluid (FF) cortisol levels affect cumulus cell (CC) lipid content during oocyte meiotic resumption, and whether CCs express genes for glucocorticoid action.

Prospective cohort study.

Academic medical center.

Thirty-seven nonobese women underwent ovarian stimulation for in vitro fertilization (IVF).

At oocyte retrieval, FF was aspirated from the first follicle (>16 mm in size) of each ovary and pooled CCs were collected.

Main Outcome Measure(s):
Follicular fluid cortisol and cortisone analysis was performed with the use of liquid chromatography–tandem mass spectrometry. CCs were stained with lipid fluorescent dye Bodipy FL C16 to determine lipid content with the use of confocal microscopy. Quantitative real-time polymerase chain reaction was used to detect CC gene expression of 11β-hydroxysteroid dehydrogenase (11β-HSD) types 1 and 2, glucocorticoid receptor (NR3C1), lipoprotein lipase (LPL), and hormone-sensitive lipase (HSL).

Adjusting for maternal age, FF cortisol levels negatively correlated with CC lipid content and positively correlated with numbers of total and mature oocytes. CCs expressed genes for 11β-HSD type 1 as the predominant 11β-HSD isoform, NR3C1, LPL, and HSL.

FF cortisol levels may regulate CC lipolysis during oocyte meiotic resumption and affect oocyte quality during IVF.

  • Paul Magarelli

    It was with great interest that I read this article. Our research on the impact of acupuncture on IVF outcomes published in Fert & Stert December 2009 Vol 92, Issue 6, Pages 1870-1879 “Changes in serum cortisol and prolactin associated with acupuncture during controlled ovarian hyperstimulation in women undergoing in vitro fertilization-embryo transfer treatment by Magarelli,Cridennda, Cohn demonstrated enhanced levels of cortisol in patients treated with the Cridennda Magarelli Acupuncture Protocol (CMAP). We did not have a clear mechanism for “why” the outcomes improved but felt certain that levels of cortisol were critical. Your study appears to support a role for cortisol that at least enhances oocyte maturity. It also corroborates our belief that combining Traditional Chinese Medicine with IVF may further enhance reproductive outcomes.

    • Daniel Dumesic

      Thank you Paul for your very kind words. Yes, I think that cortisol action within the human ovarian follicle is an exciting area of investigation. All the best. Dan

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