Effects of smoking on the levels of antioxidant beta carotene, alpha tocopherol and retinol in human ovarian follicular fluid

Effects of Supplementation with Natural Antioxidants on Oocytes and Preimplantation Embryos

For most infertile couples, in vitro fertilization (IVF) represents the only chance to conceive. Given the limited success of IVF procedures, novel approaches are continuously tested with the aim of improving IVF outcomes. Growing attention is devoted today to the potential benefit of natural antioxidants in the optimization of infertility treatments. This review summarizes current data in this context, focusing on both experimental studies on oocytes/embryos and clinical trials on antioxidants supplementation. Based on information gained from experimental studies, antioxidant supplementation may have beneficial effects on IVF outcomes in terms of quality and cryotolerance of in vitro produced embryos, together with positive effects on in vitro maturation oocytes and on early embryonic development. Unfortunately, from the clinical side, there is a paucity of evidence favoring the protective qualities of antioxidants. Among the antioxidants considered, coenzyme Q10 may be regarded as one of the most promising for its positive role in rescuing the oxidative stress-induced damages, but further data are needed. It is concluded that further trials are necessary to characterize the potential clinical value of antioxidants in IVF treatments.

Associations between follicular fluid high density lipoprotein particle components and embryo quality among in vitro fertilization patients

PURPOSE

Follicular redox balance is likely to be important for embryo quality during in vitro fertilization (IVF), and the anti-oxidative high desity lipoprotein (HDL) particle is the sole lipoprotein measured in follicular fluid (FF). Therefore, we investigated FF HDL particle components as predictors of embryo quality during IVF.

METHODS

Two research follicles collected from each participant were individually tracked, and 103 women having at least one developed embryo were included in the analysis. Concentrations of 15 non-cholesterol HDL particle components and 26 HDL-cholesterol (HDL-C) particle size subfractions were determined. Embryo quality was assessed for embryo cell number, embryo fragmentation, and embryo symmetry. Multivariable Poisson regression with a sandwich variance estimator was used to evaluate associations between HDL particle components and embryo quality, adjusted for covariates.

RESULTS

Higher γ-tocopherol concentration was associated with less embryo fragmentation (relative risk [RR] = 4.43; 95 % confidence interval [CI] 1.78, 11.06), and higher apolipoprotein A-1 concentration was associated with full embryo symmetry (RR = 3.92; 95 % CI 1.56, 9.90). Higher concentrations of HDL-C subfractions in the large and medium particle size ranges were associated with poorer embryo quality.

CONCLUSIONS

FF HDL lipophilic micronutrients and protein components, as well as HDL-C particle size, may be important predictors of embryo quality during IVF.

Variability in the components of high-density lipoprotein particles measured in human ovarian follicular fluid: a cross-sectional analysis

OBJECTIVE

To assess the variability of follicular fluid (FF) high-density lipoprotein (HDL) particle components.

DESIGN

Cross-sectional design with assessment using two-stage nested analysis of variance.

SETTING

Reproductive health center.

PATIENT(S)

180 in vitro fertilization (IVF) patients.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Nineteen HDL components including HDL cholesterol and free (unesterified) and esterified forms, phospholipids, triglycerides, apolipoproteins A-1 and A-2, paraoxonase 1 (PON1) activities, and seven lipophilic vitamins and micronutrients.

RESULT(S)

We collected FF specimens from two contralateral follicles on the day of oocyte retrieval and analyzed them for HDL components, characterizing the analytes by age, body mass index (BMI), race and smoking. For some analytes, a majority of total measurement variability was attributed to sources between follicles, suggesting an important role for the integrity of the blood-follicle barrier and in situ remodeling of plasma-derived constituents. For other analytes, variability was mostly attributed to sources between women, likely indicative of plasma levels. Variability between follicles decreased with increasing age and differed by BMI and smoking, and generally were lower for Asians and women with diminished ovarian reserve.

CONCLUSION(S)

Substantial variability in FF HDL components exist between follicles among women undergoing IVF as well as between women by age, BMI, race, smoking, and infertility diagnosis.

Follicular fluid high density lipoprotein-associated micronutrient levels are associated with embryo fragmentation during IVF

Purpose

To investigate whether follicular fluid lipid-soluble micronutrients are associated with embryo morphology parameters during IVF.

Methods

Follicle fluid and oocytes were obtained prospectively from 81 women. Embryo morphology parameters were used as surrogate markers of oocyte health. HDL lipids and lipid-soluble micronutrients were analyzed by high-pressure liquid chromatography. Non-parametric bi-variate analysis and multivariable ordinal logistic regression models were employed to examine associations between biochemical and embryo morphology parameters.

Results

Follicular fluid HDL cholesterol (r = −0.47, p < 0.01), α-tocopherol (r = −0.41, p < 0.01), δ-tocopherol (r = −0.38, p < 0.05) and β-cryptoxanthine (r = −0.42, p < 0.01) are negatively correlated with embryo fragmentation. Ordinal logistic regression models indicate that a 0.1 μmol/L increase in β-cryptoxanthine, adjusted for γ-tocopherol, is associated with a 75% decrease in the cumulative odds of higher embryo fragmentation (p = 0.010).

Conclusion

Follicular fluid HDL micronutrients may play an important role in the development of the human oocyte as evident by embryo fragmentation during IVF.

Oxidative stress and antioxidants: exposure and impact on female fertility

BACKGROUND

Reproductive failure is a significant public health concern. Although relatively little is known about factors affecting fertility and early pregnancy loss, a growing body of literature suggests that environmental and lifestyle factors play an important role. There is sufficient evidence to hypothesize that diet, particularly its constituent antioxidants, and oxidative stress (OS) may influence the timing and maintenance of a viable pregnancy. We hypothesize that conditions leading to OS in the female affect time-to-pregnancy and early pregnancy loss.

METHODS

We review the epidemiology of female infertility related to antioxidant defenses and oxidation and examine potential sources of OS from the ovarian germ cell through the stages of human pregnancy and pregnancy complications related to infertility. Articles were identified through a search of the PubMed database.

RESULTS

Female OS is a likely mediator of conception and threshold levels for OS exist, dependent on anatomic location and stage of preconception.

CONCLUSIONS

Prospective pregnancy studies with dietary assessment and collection of biological samples prior to conception with endpoints of time-to-pregnancy and early pregnancy loss are needed.

Influence of cigarette smoking on vitamin E, vitamin A, beta-carotene and lycopene concentrations in human pre-ovulatory follicular fluid

Increasing evidence suggests that fat soluble vitamins and micronutrients have the potential for local modulation of follicular development. Cigarette smoking has been associated with accelerated follicular depletion and derangement of reproductive functions. The present study was initiated to investigate the impact of cigarette smoking on follicular and plasma concentrations of vitamin A, vitamin E, lycopene and beta-carotene. Samples were collected from 17 smokers and 43 non-smoking women undergoing assisted reproduction techniques. Assays were carried out by a reverse-phase high-pressure liquid chromatography (HPLC) method. Smokers had significantly (P < 0.05) lower levels of follicular fluid beta-carotene in comparison to non-smokers (0.02 +/- 0.02 vs. 0.09 +/- 0.02, respectively). No other significant influences on follicular and plasma concentrations were noted. Smokers showed a significantly (P < 0.05) lower fertilization rate in comparison to non-smokers, (55.9 % vs. 71.5 % , respectively). It is postulated that follicular depletion of the antioxidant beta-carotene occurs in response to oxidative stress imposed by cigarette smoke.

Role of reactive oxygen species in gynecologic diseases

Free radicals derived from molecular oxygen and nitrogen are highly reactive metabolites called reactive oxygen species (ROS). Cells continuously produce free radicals and ROS as part of the metabolic process. They are involved in the various functions of the reproductive system. Antioxidants are enzymes or compounds that scavenge and reduce the presence of free radicals. Normally, a balance exists between concentrations of reactive oxygen species and antioxidant scavenging systems. The disruption of the delicate balance between pro- and antioxidants results in oxidative stress. Oxidative stress has been implicated in embryo fragmentation, DNA damage, apoptosis and poor pregnancy outcome. It has also been implicated in a large number of gynecologic diseases, such as endometriosis, pre-eclampsia and maternal diabetes. The use of antioxidants may be beneficial in combating the harmful effects of oxidative stress in many of these diseases. The present review outlines the importance of these species in the pathology of various gynecologic diseases. (Reprod Med Biol 2004; 3: 177 - 199).

Superoxide dismutase activity in human follicular fluid after controlled ovarian hyperstimulation in women undergoing in vitro fertilization

OBJECTIVE

To determine the activity of superoxide dismutase (SOD) and the total protein concentration in human preovulatory ovarian follicular fluid (FF) in relation to corresponding serum levels and the fertilization capacity of oocytes.

DESIGN

Prospective, observational study.

SETTING

Academic-based center for reproductive medicine.

PATIENT(S)

Twenty-eight female partners of infertile couples, 13 of whom were smokers, undergoing controlled ovarian hyperstimulation for IVF.

INTERVENTION(S)

Blood and follicular fluid samples were collected 34-36 hours after hCG administration.

MAIN OUTCOME MEASURE(S)

Levels of SOD activity and total protein concentrations.

RESULT(S)

Superoxide dismutase activity was present in all the FF studied and mean levels were statistically significantly higher than in serum. Total protein concentrations in serum were statistically significantly correlated with corresponding concentrations in FF. There was no difference in SOD activity between smokers and nonsmokers. Total protein concentrations in FF were marginally and statistically significantly lower in nonsmokers. Follicular fluid from patients whose oocytes did not become fertilized had a statistically significantly higher level of SOD activity than that from patients whose oocytes did become fertilized.

CONCLUSION(S)

Superoxide dismutase activity is present in FF and is higher than in serum. The degree of SOD activity is variable and seems to be inversely related to the fertilization of oocytes.

The suitability and efficiency of human follicular fluid as a protein supplement in human in vitro fertilization programs

OBJECTIVE

To evaluate the suitability and efficiency of human follicular fluid (HFF) as a protein supplement in human IVF programs.

DESIGN

Comparative study of the effects of HFF and other protein supplements on the in vitro development of mouse oocytes and on the pregnancy rate in human IVF programs.

SETTING

In Vitro Fertilization Center, Hanna Women's Clinic, Seoul, Korea.

PATIENT(S)

Three hundred twenty-seven patients (388 cycles) who were down-regulated with GnRH agonist and stimulated with hMG.

INTERVENTION(S)

The suitability was evaluated with the results of animal studies and the efficiency of HFF was investigated with the results of human IVF programs.

MAIN OUTCOME MEASURE(S)

Meiotic maturation of mouse oocytes, development of mouse embryos, morphological grades of human embryos, pregnancy rate in human IVF programs, and electrophoresis.

RESULT(S)

Human follicular fluid significantly stimulated meiotic resumption in mouse oocytes, even in the presence of meiotic inhibitors, and enhanced the developmental potential of mouse embryos in vitro. Compared with human fetal cord serum, human follicular fluid also improved the morphological grade of human embryos by reducing cytoplasmic fragmentation. In conventional IVF cycles of human IVF programs, use of HFF significantly increased the clinical PR (109/234 cycles, 46.5%; P < .05), compared with use of human fetal cord serum (14/52 cycles, 26.9%). However, in intracytoplasmic sperm injection cycles, there was no difference in PRs between use of HFF (38/85 cycles, 44.7%) and use of human fetal cord serum (7/17 cycles, 41.1%). When the protein compositions of human fetal cord serum and HFF were investigated by electrophoresis, a protein of 21 kD was detected specifically in HFF.

CONCLUSION(S)

Human follicular fluid is suitable for use as a protein supplement and is effective in increasing the pregnancy rate in human IVF programs.