Abstract
Objective: The present study is designed to prospectively evaluate relationship between follicular fluid (FF) Leptin and Activin A and IVF outcome measures. Design: Prospective observational study. Population: FF Leptin and Activin A were measured in 90 patients undergoing ICSI cycles excluding polycystic ovarian syndrome (PCOS) patients. Follicular fluid samples collected at oocyte retrieval from follicles ≥ 18 mm in diameter were analyzed for Leptin and Activin A using enzyme-linked immunosorbent assay (ELISA) and results were correlated to ICSI outcome. Main outcome measures: FF leptin and activin A levels, fertilization and pregnancy rates. Results: For the whole population (90 patients), mean follicular fluid Leptin level was 45.2 ± 26.7 ng/ml and mean body mass index was 25.3 ± 3.3 kg/m². FF Leptin had a positive correlation with BMI (p<0.005). The mean FF Activin A was 880.8 ± 354.6 pg/ml 29/90 patients (32.2%) achieved pregnancy, twenty five of them (86.2%) had more than 50% grade A embryos on day 2 in contrast to 33 patients (54.1%) in the non-pregnant group (P<0.02), this means that pregnancy was positively correlated to day 2 embryo quality. FF Leptin and Activin A did not correlate to day 2 embryo qualities or pregnancy outcome. FF total Activin A level did not relate to FF Leptin level or number of oocytes collected. Low or high FF Activin A or Leptin levels did not show an effect on fertilization, pregnancy or day 2 embryo qualities. Conclusion: Neither FF Activin A nor FF Leptin levels can be used to predict IVF outcome measures.
Highlights
Assisted reproduction is a complicated process involving multiple stages of ovarian stimulation, ovum pick up, fertilization, embryo cleavage and implantation
The mean follicular fluid (FF) Activin A was 880.8 ± 354.6 pg/ml 29/90 patients (32.2%) achieved pregnancy, twenty five of them (86.2%) had more than 50% grade A embryos on day 2 in contrast to 33 patients (54.1%) in the non-pregnant group (P
FF Leptin and Activin A did not correlate to day 2 embryo qualities or pregnancy outcome
Summary
Assisted reproduction is a complicated process involving multiple stages of ovarian stimulation, ovum pick up, fertilization, embryo cleavage and implantation. Good quality of all reproductive components and primarily embryos has a positive impact on success rates. A morphological approach of choosing good quality embryos at 2-8 cell stage based on number, equality of size and percent fragmentation [2,3] has been the method of choice of day 2 or 3 embryo transfer [4]. While inhibin and activin exert their actions mainly through a negative feedback effect on pituitary FSH, activins, mainly activin A exert their effects through local autocrine and paracrine effects on granulosa cells through action on specific receptors [5,6]. Once granulosa cells have acquired functional FSH receptors, their proliferation and differentiation would be driven mainly by FSH, but modulated by other extrinsic and locally produced factors including insulin, growth hormone and leptin [7]
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