Research Information System
26th Annual Meeting of ESHRE, Rome, Italy, 27 - 30 June 2010, vol.25, (Summary Text)
Introduction:
Leptin is the hormone used for the regulation of body weight and energy homeostasis. Ghrelin is a pleiotropic hormone, involved in the control of food intake, growth and metabolism. The close relationship between energy metabolism, nutritional state, and reproductive physiology suggests that disorders or alterations in nutritional state and metabolic disturbances can interfere with the complex interplay of gonadotropins and gonadal hormones, which are essential for fertility. This study is aimed to investigate the outcome of assisted reproduction cycles regarding to serum and follicular fluid (FF) leptin and ghrelin concentrations.
Material and Methods:
Intracytoplasmic sperm injection (ICSI) cycles from March 2006 to June 2006 (n = 44) at the Gülhane Military Medical Academy (Ankara, Turkey) for the treatment of male infertility were included in the study. Informed written consent was obtained from all cases prior to controlled hyperstimulation in this prospective study. Female age, serum baseline (D3) and FF follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) concentrations and body-mass index (BMI) were evaluated in each case related to D3 and FF leptin and ghrelin concentrations and their association with achieving a clinical pregnancy were analyzed. Long protocol was used for ovarian hyperstimulation in all cases.
Results:
Of the forty four cases included, nineteen achieved a clinical pregnancy (43,18%). There were no statistically significant differences between pregnant and non-pregnant cases in terms of D3 and FF levels of FSH (6,08 ± 3,73 and 7,21 ± 3,87 mIU/ml respectively), LH (7,24 ± 3,66 and 8,05 ± 3,47 mIU/ml), E2 (3229,25 ± 1490,57 and 2725,19 ± 2045,27 pg/ml), female age (29,5 ± 4,18 and 31,22 ± 4,17) and BMI (24,91 ± 3,68 and 25,8 ± 3,93). D3 and FF ghrelin values were evaluated for their relationship with clinical pregnancies and a multiple variable logistic regression analysis was performed. Amongst the parameters investigated, D3 and FF ghrelin levels were not associated with clinical pregnancies (10,2 ± 5,92 and 9,15 ± 3,99 ng/ml respectively). Although FF leptin levels were not different between pregnant and non-pregnant cases (922,88 ± 53,08 and 885,78 ± 143,54 pg/ml respectively) D3 leptin levels were found to be negatively correlated with clinical pregnancies in an independent manner from all of the other parameters investigated, including BMI and female age (899,93 ± 61,79 and 937,51 ± 45,18 pq/ml in pregnant and non-pregnant cases respectively, P = 0,039).
Conclusions:
Although many reports have described a poor reproductive prognosis in obese women both in natural and assisted conception cycles, our data did not demonstrate a tendency through a lower chance of conception with regard to ghrelin and BMI values. Our study shows a correlation between D3 leptin values and success after assisted reproduction. In our study, E2 did not affect the production of leptin. D3 leptin appears to constitute an additional prognostic indicator of ICSI outcome and our study demonstrates a BMI-independent correlation between D3 leptin and ICSI outcome. Future studies exploiting the effectiveness of the ICSI model will be useful in further delineating the role for the agents involved in energy and metabolism in the human body. It is expected that future research will clarify the reproductive importance of leptin and ghrelin.