with the case of women with male-factor infertility (controls). MATERIALS AND METHODS Subjects

Follicular fluid was collected during routine egg retrieval from 106 consecutive women undergoing controlled ovarian stimulation in preparation for IVF or ICSI. Women with male-factor infertility and no other causes constituted the control group (47 women). Polycystic ovary syndrome (PCOS) was diagnosed according to Rotterdam criteria (13 women) (16). Unexplained infertility was diagnosed when routine tests for infertility workup did not reveal any abnormality (22 women). Diminished ovarian reserve was diagnosed with a day 3 FSH level of>10 mIU/mL, with an antral follicle count of <5 in one ovary or of <10 in both ovaries, or when five or fewer eggs were retrieved after a routine controlled ovarian hyperstimulation (17 women). Patients with a history of endometriosis were diagnosed by laparoscopy (7 women). This study was approved by the institutional review board of Maimonides Medical Center. Follicular-fluid Collection Aspirates were obtained from the first follicle from either side in an effort to obtain clear follicular fluid. After removal of the oocyte, the fluid was processed by centrifuge at 1,000 rpm for 10 minutes, and the clear supernatant was stored at 80 C until assayed. Only clear follicular fluid associated with the presence of an oocyte, without blood or flushing solution, was collected.