Table 1. Biomarkers analyzed in follicular fluid: a summary review results for oocyte evaluation in assisted reproductive technologies.
Study Study design Oocyte quality predictor Samples size Main outcomes p-value
Carpintero
et al. (2014)
Prospective cohort Estradiol, progesterone, testosterone, DHEAS FF from ICSI patients (n=31) In FF with MII oocytes, testosterone positively correlated with progesterone (r=0.794 for normal fertilization; r=0.829 for failed fertilization) <0.0001 both
Santonocito et al. (2014) Crosssectional miRNAs FF from ICSI patients (n=15) 37 upregulated in FF compared to plasma, with 32 in microvesicles expressing CD63 and CD81, impacting key follicle growth and oocyte maturation pathways NA
Bastu et al. (2015) Retrospective cohort Cathepsin B FF from IVF patients (n=79) Cathepsin B levels, total oocytes, MII oocytes, and MII rate were higher in pregnant compared to nonpregnant patients <0.05 all
Meijide et al. (2017) Prospective case-control PONs FF from patients (n=155) PONs activities were higher in larger follicles (diameter ≥18 mm) than in smaller ones (diameter <12mm); <0.001
In donors, PON1 arylesterase and paraoxonase activities showed positive correlations (R2=0.078 and R =0.073, resp.) <0.05 both
Fu et al. (2018) Case-control miRNAs FF from ICSI patients (n=91) MIR-663B was negatively expressed in FF of oocytes that yielded viable blastocysts compared to those that did not 0.019
Bouet et al. (2020) Cross-sectional Cytokine Profile FF from IVF/ICSI patients (n=57) PDGF-BB and RANTES was lower in DOR than NOR; 0.05, 0.023,
MCP-1 and IL-1RA was elevated in DOR; 0.030, 0.041
Fewer oocytes in DOR than NOR 0.003
Karabulut
et al. (2020)
Prospective cohort TAS; TOS FF from ICSI patients (n=166) Mature oocyte rates were decreased in the HOS group 0.002
Latif Khan
et al. (2020)
Prospective cohort cfDNA; melatonin FF (n=895) from IVF patients (n=325) Intra-follicular cfDNA negatively correlated with elevated melatonin levels in FF samples of mature oocytes <0.001
Uppangala
et al. (2020)
Prospective cohort E2; MDA FF from ART patients (n=30) Patients with poor ovarian response and serum E2 <2000pg/mL had elevated MDA levels, with an inverse relationship observed between serum E2 and follicular MDA levels <0.01 both
Yi et al. (2020) Prospective cohort Prdx4 FF from IVF/ICSI patients (n=138) Pdx4 was positively correlated with the oocyte fertilization rate and showed a hight accuracy for clinical pregnancy prediction (AUC= 0.754) 0.011,<0.01,
resp.
Wyse et al. (2021) Retrospective Adiponectin; chemerin; Creactive protein; IL-6; IL-10; IL-18; insulin; leptin; prolactin; resistin; TNF-α; BMP- 15 FF from IVF patients (n=44) TNF-α and leptin were positive predictors of oocyte maturation (OR=10.2 and 1.2, resp., AUC=0.8); 0.01, 0.04,
resp.
IL-10 was predictive of oocyte maturation after controlling for BMI (OR 1.3x1012; AUC=0.98) 0.02
Ekapatria
et al. (2022)
Cros-ssectional Vitamin D FF (n=77) from IVF patients (n=77) Vitamin D level in FF was positively correlated with oocyte quality (r=0.32) 0.01
Molka et al. (2022) Prospective and
longitudinal
IGF1; GH; IL-6; IL-7 FF from IVF/ICSI patients (n=140) GH, IGF1, and IL-6 values were higher in group of patients aged ≥ 35 or with development failure or RIF antecedent; 0.001, 0.001, <0.05, resp.
ROC curve between IL-6 and implantation rate of ongoing pregnancy found an IL-6 cutoff >9.85pg/ml (AUC+0.6) 0.04
Yu et al. 2022) Prospective cohort LH; FSH; cortisone FF (n=136) from IVF/ICSI patients (n=138) FF levels of 17-OHP, testosterone and cortisone level were lower in oocytes of top-quality blastocysts on D5 than the unfertilized group FF DHT concentrations were lower in fertilized follicles after ICSI than in follicles with unfertilized oocytes <0.05

ART: assisted reproductive technology; BMP-15: bone morphogenetic protein 15; cfDNA: cell-free 913 DNA; DOR: diminished ovarian reserve; E2: estradiol; FF: follicular fluid; FSH: follicle-stimulating hormone; GH: growth hormone; HOS: high oxidative stress; ICSI: intracytoplasmic sperm injection; IGF1: insulin-like growth factor 1; IL: interleukin; IVF: in vitro fertilization; LH: luteinize ng hormone; MDA: malondialdehyde; MII: metaphase II oocyte; MCP-1: CCL2; miRNAs: microRNAs; NA: not applicable; NOR: normal ovarian reserve; PONs: paraoxonases; Prdx4: peroxiredoxin 4; RANTES: CCL5; 918 TAS: Total Antioxidant Status; TOS: Total Oxidant Status; TNF-α: tumor necrosis factor-alpha; DHEAS: dehydroepiandrosterone sulfate; DHT: dihydrotestosterone; 17-OHP: 17-hydroxy pregnenolone; D5: day 5; IL-1RA: IL-1 receptor antagonist; PDGF-BB: platelet-derived growth factor-BB.