Abstract
Objective: To investigate the relationship between serum leptin and reproductive hormones in females with unexplained infertility (UI).Methodology: It was a case-control study conducted in the Gynecology and Obstetrics Department and Infertility Clinic, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan. A total of 235 primary infertile females with an unidentified cause of infertility were selected from the Infertility Clinics. The patients were excluded if they were found to have polycystic ovary syndrome, endometriosis, tubal blockage, irregular menstrual cycles, hyperthyroidism, hypothyroidism, hyperprolactinemia, hyperandrogenemia, fasting blood sugar >110 mg/dl, and male factor infertility. A total of 205 healthy, fertile females were selected from the general population. The blood samples of both groups were collected on the 12th and 21st day of their menstrual cycle. Serum leptin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and E2 levels were measured. Statistical analysis was executed using the SPSS version 16 (SPSS Inc., Chicago, IL).Results: No significant difference was observed in leptin values of fertile and UI females, 37.110±1.19 vs. 35.321±0.901. In the preovulatory phase (12th day) of the cycle, infertile subjects with body mass index (BMI) <20 and 20-24.9 had significantly higher values for leptin (p<0.05), whereas, with an increase in BMI, leptin levels were reduced in these females. Leptin was reduced further in the luteal phase of infertile females with BMI 25-30, with a significantly lower value for FSH (p<0.005), LH (p<0.005), and estradiol (p<0.005. In infertile subjects, it correlated with estradiol (r=0.501, p<0.005), BMI (r=0.903, p<0.001), and progesterone (r=0.146, p<0.05).Conclusion: Low levels of leptin observed to have an increase in the BMI of UI females were associated with a reduced estradiol and progesterone production in the luteal phase of the cycle.
Highlights
Infertility is the inability of a sexually active couple, not using any contraceptive techniques in a year or more, to get pregnant [1]
In the preovulatory phase (12th day) of the cycle, infertile subjects with body mass index (BMI)
All selected infertile female subjects and control fertile female subjects were categorized according to their BMI and were further grouped according to their phases of the menstrual cycle, that is, preovulatory and luteal phases
Summary
Infertility is the inability of a sexually active couple, not using any contraceptive techniques in a year or more, to get pregnant [1]. Infertile couples suffer from trauma and depression when they experience delays, challenges, and disappointments in achieving reproduction. A product of the ob gene which is primarily produced by adipose tissues, helps to regulate the hypothalamic-pituitary-gonadal axis and plays a vital role in obesity, hyperinsulinemia, and increased insulin resistance in the polycystic ovary syndrome (PCOS) patients [3]. An association of leptin with obesity, infertility, and other endocrine functions has been reported [4]. Circulatory leptin levels are considered to be a predictor of menstrual function. Leptin does modify gonadotropin-releasing hormone and gonadotrophin production, but it plays an important role in the functioning of the ovary and endometrium and takes part in the development of an embryo [6]
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