Upper critical level of ROS in follicular fluid for predicting outcome failure in women with endometriosis undergoing IVF

Abstract

OBJECTIVE: Reactive oxygen species (ROS) in follicular fluid (FF) has been reported to play a detrimental role in oocyte quality, fertilization and embryo formation. The present study attempts to establish an upper critical limit (UCL) in FF of women with tubal block using control chart analysis. In addition, ROS level was estimated and IVF outcome parameters compared in FF of women with endometriosis to validate the established UCL.DESIGN: Women reporting for IVF-ET by controlled ovarian stimulation (long protocol) were included in this study. ROS levels were measured in 112 FF samples from 29 women with tubal factor infertility (control group) and in 91 FF samples from 34 women with endometriosis. The upper critical limit of FF ROS level was estimated using control chart analysis at 3 sigma level. According to the estimated UCL of ROS, the endometriosis patients were sub-divided into two groups: Group I with ROS level <100 counted photons per second (cps) and Group II having ROS level > 100 cps. Oocyte quality, fertilization rate, embryo formation and quality were compared in Group I and Group II.MATERIALS AND METHODS: 400 μl of centrifuged supernatant was taken in the luminometer cuvette and 10 μl of luminol (5 mM) in DMSO was added to it. Each sample was scanned for 10 min and ROS values were expressed as cps.Table 1Grade III oocyte formation, fertilization rate and Grade I embryo formation corrosponding to the FF ROS level >UCL (100 cps) and <UCLPatient GroupROS levels in FF% of Grade III oocyte formationP valueFertilization rate (%)P value% of Grade I embryo formationP valueEndometriosis<UC L (< 100 cps)89.3P≤0.0578.6P≤0.0582.7P≤0.05Endometriosis>UCL (> 100 cps)16.218.212.5 Open table in a new tab CONCLUSIONS: The results suggest that ROS levels in FF above 100 cps tend to significantly affect IVF outcome parameters. This study is expected to assist clinicians in predicting outcome failure in women with endometriosis undergoing IVF. OBJECTIVE: Reactive oxygen species (ROS) in follicular fluid (FF) has been reported to play a detrimental role in oocyte quality, fertilization and embryo formation. The present study attempts to establish an upper critical limit (UCL) in FF of women with tubal block using control chart analysis. In addition, ROS level was estimated and IVF outcome parameters compared in FF of women with endometriosis to validate the established UCL. DESIGN: Women reporting for IVF-ET by controlled ovarian stimulation (long protocol) were included in this study. ROS levels were measured in 112 FF samples from 29 women with tubal factor infertility (control group) and in 91 FF samples from 34 women with endometriosis. The upper critical limit of FF ROS level was estimated using control chart analysis at 3 sigma level. According to the estimated UCL of ROS, the endometriosis patients were sub-divided into two groups: Group I with ROS level <100 counted photons per second (cps) and Group II having ROS level > 100 cps. Oocyte quality, fertilization rate, embryo formation and quality were compared in Group I and Group II. MATERIALS AND METHODS: 400 μl of centrifuged supernatant was taken in the luminometer cuvette and 10 μl of luminol (5 mM) in DMSO was added to it. Each sample was scanned for 10 min and ROS values were expressed as cps. CONCLUSIONS: The results suggest that ROS levels in FF above 100 cps tend to significantly affect IVF outcome parameters. This study is expected to assist clinicians in predicting outcome failure in women with endometriosis undergoing IVF.