In vitro fertilization
Associations between free fatty acids, cumulus oocyte complex morphology and ovarian function during in vitro fertilization

https://doi.org/10.1016/j.fertnstert.2011.01.154Get rights and content

Objective

To determine if follicular free fatty acid (FFA) levels are associated with cumulus oocyte complex (COC) morphology.

Setting

University in vitro fertilization (IVF) practice.

Patient(s)

A total of 102 women undergoing IVF.

Intervention(s)

Measurement of FFAs in serum and ovarian follicular fluid.

Main Outcome Measure(s)

Total and specific follicular and serum FFA levels, correlations between follicular and serum FFAs, and associations between follicular FFA levels and markers of oocyte quality, including COC morphology.

Result(s)

Predominant follicular fluid and serum FFAs were oleic, palmitic, linoleic, and stearic acids. Correlations between follicular and serum FFA concentrations were weak (r = 0.252, 0.288, 0.236, 0.309, respectively for specific FFAs; r = 0.212 for total FFAs). A receiver operating characteristic curve determined total follicular FFAs ≥0.232 μmol/mL distinguished women with a lower versus higher percentage of COCs with favorable morphology. Women with elevated follicular FFAs (n = 31) were more likely to have COCs with poor morphology than others (n = 71; OR 3.3, 95% CI1.2–9.2). This relationship held after adjusting for potential confounders, including age, body mass index, endometriosis, and amount of gonadotropin administered (β = 1.2; OR 3.4, 95% CI 1.1–10.4).

Conclusion(s)

Elevated follicular FFA levels are associated with poor COC morphology. Further work is needed to determine what factors influence follicular FFA levels and if these factors impact fertility.

Section snippets

Patient Characteristics and Samples

Washington University’s Institutional Review Board approved all study protocols. Women were enrolled the morning of oocyte retrieval after undergoing controlled ovarian hyperstimulation (COH) with injected gonadotropins as previously described (11). Inclusion criteria were first IVF cycle and age <38 years. Women were excluded if they had not undergone our standard COH protocol, if they had known stage III/IV endometriosis, or if sperm used in their procedures was obtained from testicular

Patient Characteristics

A total of 102 women were enrolled. Average patient age was 32.7 ± 3.5 years. Average BMI was 25.38 ± 5.1 kg/m2. Forty-one subjects were overweight, 23 were parous, and six used tobacco. Infertility diagnoses included PCOS (n = 6), other ovulation disorder (n = 13), fallopian tube abnormalities (n = 20), endometriosis (n = 8), and male factor infertility (n = 35). Several participants had multiple diagnoses, and 22 had unexplained infertility.

FFAs in Serum and Ovarian Follicular Fluid

Follicular fluid was available for 102 patients and

Discussion

Our findings demonstrate that predominant FFAs in the ovarian follicle include oleic, palmitic, stearic, and linoleic acids, the latter being an essential FFA obtained from the diet whereas the others are synthesized by the body. The predominant FFAs in the ovarian follicle were consistent with those found in serum; however, concentrations of FFAs in follicular fluid had only a weak correlation with FFAs in serum. These results suggest that cells of the ovarian follicle metabolize specific FFAs

Acknowledgments

The authors thank Dr. David Alpers for his review of this manuscript, participating patients, Jennifer Shew and Freida Custudio for technical assistance with FFA measurement, the Women’s Health Specimen Consortium at Washington University for assistance with patient enrollment, and the nursing and laboratory staff at Washington University’s Center for Reproductive Medicine and Infertility for their assistance in specimen processing.

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  • Cited by (0)

    E.S.J. has nothing to disclose. G.A.M. has nothing to disclose. R.R.O. has nothing to disclose. B.W.P. has nothing to disclose. S.E.L. has nothing to disclose. V.S.R. has nothing to disclose. K.H.M. has nothing to disclose.

    Supported by National Institutes of Health (NIH) grants K12HD063086-01, UL1RR024992, P30DK056341, and L50HD062021-01. The contents of this work are the responsibility of the authors and do not necessarily represent the official views of the NIH.

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