Follicular fluid leptin levels and insulin resistance as Predictors of pregnancy rate in ICSIcycles

Abstract

Infertility is one of the most important and common diseases of the genital system and is defined as non-pregnancy after 12 months of sex without the use of preventive methods. In recent decades, pregnancy through intracytoplasmic sperm injection (ICSI) has been used as one of the valuable and powerful methods for the treatment of infertility. So far, a number of factors have been identified in the ICSI results. Obesity is a common problem in today's society and is common in women of childbearing age and has a negative effect on reproductive health and is associated with menstrual disorders, infertility, insulin resistance, ovulation failure and inadequate ovarian response to ovulation induction. Leptin is a small peptide molecule that is secreted by fat cells and plays an important role in regulating body fat. There is a relationship between weight gain and insulin resistance and serum leptin levels. Increased levels of serum leptin and follicular fluid can have an inhibitory role in follicular growth and development. Materials and Methods: forty infertile women referred to the infertility clinic of Al-Zahra Hospital in Tabriz, Iran, were enrolled in this study because of male factor ICSI. In these patients other data including height, weight, BMI, number of follicles, number of oocytes and embryos were obtained after puncture. Subsequently, the subjects will be referred to the laboratory and all of them will receive 5 cc of venous blood for fasting blood glucose, insulin levels, serum leptin levels, and insulin resistance. After ovulation stimulation with gonadotropins, when three or more dominant follicles were identified in ultrasound, HCG was administered to patients undergoing ovarian puncture and follicular fluid was assessed for estrogen, progesterone, and leptin levels. The ICSI embryos were then transferred into the uterus and fertilization and pregnancy rates were determined during the cycles.

Results: There was a significant difference between the mean BMI in women with positive embryo transfer and women with negative embryo transfer (p <0.0001). Also, insulin levels and insulin resistance were significantly higher in those with negative embryo transfer (p <0.0001). Serum leptin and follicular fluid levels were higher in women with unsuccessful embryo transfer than in women who had positive ICSI transfer (p <0.0001). The results of another part of the present study showed that there was no significant difference in serum concentrations of FSH, estradiol and progesterone between the two study groups (group with successful and unsuccessful embryo transfer).