The interaction between follicular fluid total antioxidant capacity, infertility and early reproductive outcomes during in vitro fertilization

Abstract

Introduction: The objective of this study was to determine whether the relationship between antioxidant capacity of follicular fluid and early reproductive outcomes is influenced by the cause of infertility, polycystic ovarian morphology, age and smoking.Patients and methods: This was a prospective, cross-sectional study performed in an assisted conception unit and a teaching hospital. The study cohort was 34 women undergoing IVF treatment. Interventions included total antioxidant capacity (TAC) measured using ferric reducing/antioxidant power assay in 303 follicular fluid samples. The main outcome measures were follicular fluid TAC, percentage TAC loss after 72 h and early reproductive outcomes.Results: Follicular TAC was elevated in women with infertility of 'unexplained' (UE) or tubal factor (TF) aetiology, relative to those with male factor (MF) infertility, when reproductive outcomes were positive but not when they were negative. In the TF and UE groups, low TAC was associated with ovum fertilization incompetence, whereas TAC was comparable irrespective of embryo viability. Unexplained infertility was associated with significantly elevated follicular TAC. Among women with polycystic ovaries, fertilization incompetence was associated with elevated TAC; the opposite was true in women with normal ovaries. Follicular fluid 72-h TAC consumption > 20% was associated with poorer reproductive performance.Conclusions: The follicular fluid pro-oxidant-antioxidant balance required for conception in women undergoing IVF is related to the aetiology of infertility, age, the presence of polycystic ovary morphology and smoking.