Influence of pituitary suppression and controled ovarian hyperstimulatin (COH) on oxidative stress markers of infertile patients with polycystic ovary syndrome (PCOS) and controls

Abstract

OBJECTIVE: Recent evidence has suggested the presence of systemic oxidative stress (OS) in PCOS women. OS may be involved in dysfolliculogenesis observed in PCOS patients and hypothetically may be influenced by COH. Our objectives were to compare the levels of malondialdehyde (MDA) and advanced oxidation protein products (AOPP) in serum of non-obese infertile PCOS women and of non-obese ovulatory patients with infertility due to tubal and/or male factor (control) during early follicular phase of the menstrual cycle preceding COH (D1), after pituitary suppression (D2) and during COH, human corionic gonadotropin (hCG) administration day (D3) and oocyte retrieval day (D4). DESIGN: Prospective study. MATERIALS AND METHODS: The study was conducted on 72 patients (16 cycles of 15 PCOS patients and 66 cycles of 57 control patients). Peripheral blood was collected during early follicular phase of the menstrual cycle preceding COH (D1), ten days after gonadotropin-releasing hormone (GnRH) agonist use (D2), at hCG administration (D3) and at oocyte retrieval day (D4). MDA and AOPP levels were determined by absorbance readings. Total protein (pt) were determined by Labtest Kits. RESULTS: MDA levels were significantly higher in PCOS women than in controls in D1 (27.9 ± 8.9 μmol/g pt and 22.6 ± 9.0 μmol/g pt, respectively), D3 (28,7 ± 6,9 μmol/g pt and 24,2 ± 7,4 μmol/g pt), and D4 (29,2 ± 5,4 μmol/g pt and 23,3 ± 7,2 μmol/g pt). MDA levels increased after pituitary suppression only in controls (D1=22,6 ± 9,0 μmol/g pt and D2=25,9 ± 9,1 μmol/g pt). AOPP levels were similar between groups in D1, D2, D3, and D4. CONCLUSION: Non obese, oligomenorrheic, and infertile PCOS women have evidence of increased systemic oxidative stress expressed by higher malondialdehyde levels, a lipid peroxidation (LP) marker, not only in natural cycles, but also after COH (hCG administration and oocyte retrieval day) for ICSI. Pituitary suppression was not related to increased LP in PCOS women.