Number of oocytes and IVF outcomes: Real-world evidence

New aspect on the regulation of in vitro oocyte maturation: role of the obesity, neuropeptides and adipokines

Oocyte quality determinants and nuclear and cytoplasmic maturation establish essential processes for fertilization and further development of the conceptus. Moreover, female fertility is strongly dependent on the metabolic status of the organism. Numerous sources indicate that obesity impairs ovarian function including oocyte physiology by inhibiting nuclear maturation, stimulating lipotoxicity and inflammation, enabling cumulus cells apoptosis, promoting reactive oxygen species formation and ultimately imposing pathogenic effects on mitochondria leading to infertility. Whereas, the number of overweight and obese individuals has reached alarming levels over the past decades, what is more, by 2030, the prevalence of overweight and obesity might reach 65.3% in adults in China and 78% in the USA. Thus, relationships between reproduction and metabolism are being intensively studied to prevent obesity-induced infertility. The metabolic markers of oocyte condition and function are adipokines and neuropeptides, which regulate food intake, lipid and glucose metabolism, insulin resistance and impart significant influences on reproduction. Thus, in this review, we focus on interrelationships between obesity, oocyte maturation and the role of selected neuropeptides and adipokines including leptin, adiponectin, kisspeptin, nesfatin-1, phoenixin, visfatin, chemerin and vaspin.

Intra-ovarian inflammatory states and their associations with embryo quality in normal-BMI PCOS patients undergoing IVF treatment

BACKGROUND

Polycystic ovary syndrome (PCOS) is the main cause of anovulatory infertility in women of reproductive age, and low-grade chronic inflammation plays a key role in the occurrence and development of PCOS. However, obesity, as a likely confounding factor, can affect the inflammatory state of PCOS patients.

OBJECTIVE

The aim of this study was to comprehensively investigate intra-ovarian inflammatory states and their impact on embryo quality in PCOS patients with a normal BMI undergoing IVF treatment.

METHODS

DIA-mass spectrometry-based proteomics and bioinformatic analysis were combined to comprehensively profile the protein expression of granulosa cells (GCs) from 5 normal-BMI PCOS patients and 5 controls. Thirty-four cytokines were further systematically detected in follicular fluid (FF) from 32 age- and BMI-matched normal-BMI patients using Luminex liquid chip suspension technology. Next, the differentially expressed cytokines were evaluated by enzyme-linked immunosorbent assay (ELISA) in 24 newly recruited subjects, and the relationship between these cytokines and embryo quality in PCOS patients was analysed. Finally, these cytokine levels were compared and evaluated in PCOS patients with different androgen levels.

RESULTS

Proteomic analysis showed that the suppression of substance metabolism and steroid biosynthesis, more interestingly, resulted in an enhanced immune and inflammatory response in the GCs of normal-BMI PCOS patients and prompted the involvement of cytokines in this process. Luminex analysis further showed that FF macrophage inflammatory protein-1 beta (MIP-1β) and stromal cell-derived factor-1 alpha (SDF-1α) levels were significantly increased in normal-BMI PCOS patients compared to controls (P = 0.005; P = 0.035, respectively), and the ELISA results were consistent with these findings. Besides, FF MIP-1β showed an inverse correlation with the number of D3 good-quality embryos and the good-quality blastocyst rate in patients with PCOS (P = 0.006; P = 0.003, respectively), which remained significant after correction for multiple comparisons. Moreover, SDF-1α levels had no relationship with embryo development in PCOS patients. Additionally, SDF-1α levels were significantly lower in PCOS patients with high androgen levels than in controls (P = 0.031).

CONCLUSIONS

Local ovarian inflammation was present in normal-BMI PCOS patients, affecting follicular development, and FF MIP-1β may be a potential biomarker associated with embryo quality in normal-BMI PCOS patients.