Abstract
Adipokines produced by adipose tissue are involved in the regulation of steroidogenesis and folliculogenesis and affect embryo implantation and endometrial receptivity. As a result, the adipokine levels and their ratio in the follicular fluid can be used to evaluate the effectiveness of the in vitro fertilization (IVF). The aim was to study the effect of the leptin, adiponectin and ghrelin levels and their ratios in the follicular fluid of women with the normal and increased body weight on the effectiveness and outcome of IVF. We studied women with normal body weight who became pregnant (PN, n = 7) or who did not become pregnant (nPN, n = 14) as a result of IVF, and overweight women (BMI > 25 kg/m2), who became pregnant (PO, n = 5) and not pregnant (nPO, n = 19) after IVF. In the PN group, the level of leptin in the follicular fluid was higher than in the nPN group (p < 0.05). In the PO and nPO groups, it did not differ, but was higher than in the groups with normal body weight. In the PN group, the ghrelin level was lower than in the nPN group (p < 0.05), while in the PO and nPO groups it was comparable. The leptin/adiponectin ratio in the PN group was higher than in the nPN group (7.05±0.84 versus 2.97±0.44, p < 0.05), but lower than in the PO (13.80±2.28) and nPO (11.28±1.03) groups. The leptin/ghrelin ratio in the PN group was also higher than in the nPN group (18.46±4.20 vs. 4.07±0.68, p < 0.05), but lower than in the PO (37.46±21.59) and nPO (25.17±3.97) groups. The prognostic significance of the leptin/ghrelin ratio was 25.13 (CI 1.24-509.15, p = 0.035). The adiponectin levels and the adiponectin/ghrelin ratio in the investigated groups did not differ. Thus, the prognostic significance of the leptin and ghrelin levels and the leptin/ghrelin and leptin/adiponectin ratios in the follicular fluid is due to the patient’s body weight and metabolic status. The concentration of leptin and the ratio of leptin/ghrelin in the follicular fluid can be considered as valuable markers for assessing the success of IVF in women with normal body weight.
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