Abstract
BackgroundLipids are an important source for energy production during oocyte maturation. The accumulation of intracellular lipids binds to proteins to form lipid droplets. This may lead to cellular lipotoxicity. The impact of lipotoxicity on cumulus and granulosa cells has been reported. This pilot study evaluated their correlation to oocyte and embryo quality.DesignProspective case-control study.Setting: Referral IVF unit.Patients: Women younger than age 40, undergoing IVF with intracytoplasmic sperm injection.Interventions: 15 women with BMI > 30 (high BMI) and 26 women with BMI < 25 (low BMI) were enrolled. IVF outcomes were compared between groups based on BMI. Lipid content in cumulus and granulosa cells was evaluated using quantitative and descriptive methods. Lipid profile, hormonal profile and C-reactive protein were evaluated in blood and follicular fluid samples. Demographic and treatment data, as well as pregnancy rates were collected from electronic medical records.ResultsHigher levels of LDL and CRP, slower cell division rate and lower embryo quality were found in the group with high BMI. There was no difference in pregnancy rates between groups. In light of these findings, treatment outcomes were reanalyzed according to patients who became pregnant and those who did not. We found that patients who conceived had significantly lower fat content in the granulosa cells, reflected by mean fluorescence intensity recorded by flow cytometry analysis (23,404 vs. 9370, P = 0.03).ConclusionsBMI has no effect on lipid content in cumulus and granulosa cells, and does not affect likelihood of pregnancy. However, women who achieved pregnancy, regardless of their BMI, had lower lipid levels in their granulosa cells. This finding is important and further study is needed to evaluate lipid content in granulosa cells as a potential predictor of IVF treatment success.
Highlights
Obesity is a worldwide epidemic and a risk-factor for many diseases
We found that patients who conceived had significantly lower fat content in the granulosa cells, reflected by mean fluorescence intensity recorded by flow cytometry analysis (23,404 vs. 9370, P = 0.03)
Our data revealed no direct correlation between BMI and lipid droplet accumulation and clinical outcomes, we found an increase in fluorescence, possibly resulting from an increase in the number and size of lipid droplets, which was significantly associated with lower pregnancy rates
Summary
Obesity is a worldwide epidemic and a risk-factor for many diseases. The effect of obesity on female fertility has been examined extensively and a significant relation was found between obesity and the reproductive system. Obese women have lower spontaneous pregnancy rates and increased risk for spontaneous abortion. They present with higher incidence of ovulation disorders, and infertility compared to normal weight women. Lipids are an important source for energy production during oocyte maturation, fertilization, and preimplantation development. Lipids are an important source for energy production during oocyte maturation. The accumulation of intracellular lipids binds to proteins to form lipid droplets. The impact of lipotoxicity on cumulus and granulosa cells has been reported This pilot study evaluated their correlation to oocyte and embryo quality
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