[Tissue-type plasminogen activator (T-PA) and plasminogen activator inhibitor (PAI-1) in human follicular fluid during gonadotropin-induced ovulation].

Objectives: Plasminogen activators and their inhibitors have been implicated in the process of fibrinolysis, tissue remodeling, and ovulation. To evaluate the role of t-PA and PAI-1 in human ovulation, we obtained follicular fluid (FF) from preovulatory follicles of patients undergoing IVF-ET. Concentrations tPA and PAI-1 were analyzed in relation to oocyte maturation. Levels of tPA and PAI-1 obtained after COH were compared to the tPA and PAI-1 concentrations in the follicular fluid of healthy, fertile women.

Materials And Methods: FF was collected from 66 infertile patients undergoing ovulation induction using either short or long protocol. FF was obtained 36 hours after hCG (Pregnyl) administration. The control group consisted of 16 fertile women with unstimulated cycles. Concentrations of t-PA Ag and PAI-1 Ag were measured using Elisa kits (Bioopol).

Results: The average follicular fluid tPA concentration of patients undergoing IVF-ET treatment was significantly lower (0.039 vs 0.117 ng/mg protein; p < 0.0005), whereas PAI-1 significantly higher (3.261 vs 0.135 ng/mg; p < 0.0001) compared to the control group. Concentrations of tissue-type plasminogen activator in FF of patients with 5 or more mature oocyte were significantly lower (0.017 vs 0.056 ng/mg) and levels of PAI-1 higher (3.49 vs 2.9 ng/mg) in comparison to cases involving < 5 oocytes.

Conclusions: 1. Concentration of tPA in the follicular fluid is significantly lower whereas PAI-1 level significantly higher in patients undergoing COH. 2. Follicular fluid tPA and PAI-1 concentrations may be a crucial factors reflecting oocyte maturity.