Get access

Total Cortisol Levels are Reduced in the Periovulatory Follicle of Infertile Women with Minimal–Mild Endometriosis


Address reprint requests to M.P. Smith, Division of Obstetrics and Gynaecology, St Michael's Hospital, Southwell St, University of Bristol, Bristol BS2 8EG, UK. E-mail:


PROBLEM: To measure and compare concentrations of total and free glucocorticoids with oocyte fertilizing capacity in the follicular fluid (FF) of women with minimal–mild endometriosis and tubal damage.

METHOD OF STUDY: Follicular fluid was collected from individual periovulatory follicles during oocyte retrieval for in vitro fertilization (IVF) in natural cycles. Total and free levels of cortisol and cortisone were measured using specific radioimmunoassays after chloroform extraction.

RESULTS: Cortisol concentrations in women with minimal–mild endometriosis were significantly lower compared with controls (women with tubal infective damage) (258 versus 328 nmol/L, P < 0.02). There was no correlation between total or free concentrations of cortisol or cortisone and the fertilization capacity of the oocyte.

CONCLUSIONS: Total cortisol levels are lower in the follicles of women with endometriosis. Our findings provide further evidence of follicular dysfunction contributing to the subfertility associated with minimal–mild endometriosis.