Follicular Fluid (FF)

Definition - What does Follicular Fluid (FF) mean?

Follicular fluid (FF) is a liquid contained in the ovarian follicle and bathes the ovum (or egg) in an ovarian follicle. The follicular fluid contains hormones and other substances like sugars and antioxidants. Rupturing of the follicle during ovulation releases the fluid and its contents into the ovaries. The fluid transiently bathes the surface of ovaries and Fallopian tube during ovulation. FF is easily accessible during egg retrieval and provides an optimal source for determining egg quality.

FertilitySmarts explains Follicular Fluid (FF)

Follicular fluid (FF) offers a favorable environment for the development of eggs within the follicles. The fluid can be aspirated to determine egg quality. FF contains several components, including but not limited to:

A. Hormones:

1. FSH and LH: High FF concentrations of FSH, hCG, and LH in the follicular fluid favor egg maturation and are associated with eggs carrying a high probability of fertilization. These hormones boost the egg quality, leading to better embryos, improved pregnancy rate, and successful IVF attempts.

2. Estrogen, progesterone, and androgen: High estrogen levels in the FF promote egg maturation whereas high androgen levels hinder egg maturation and impair the egg quality. That said, a certain amount of androgens is still required for optimal follicular growth.

Growth factors:

1. Insulin-like growth factor (IGF)-I: Promotes cell growth and proliferation.

2. Anti-mullerian hormone (AMH): It is a product of the cells of the ovarian follicles. High AMH levels are a good predictor of high-quality eggs that have a high chance of being fertilized and yielding a healthy embryo.

Sugars:

1. Myo-inositol: Raised myo-inositol concentrations correlate with high estradiol (estrogen) levels and both indicate that eggs are of good quality. Myo-inositol therapy is also used for poor-responders during IVF and even before IVF. It improves egg maturation and the resultant embryo quality.

Prostanoids

Prostaglandin: It is a recognized biochemical marker of the egg quality, as it is found at higher concentrations in the FF of follicles whose eggs have a high potential of being fertilized.

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