Follicular fluid cytokine composition and oocyte quality of polycystic ovary syndrome patients with metabolic syndrome undergoing in vitro fertilization

Purpose: To provide insights into the correlation among lipid metabolism, cytokine profiles in the follicular fluid (FF) and embryo quality of women with Polycystic Ovary Syndrome (PCOS) with metabolic syndrome (MS). Methods: Ninety women undergoing in vitro fertilization (IVF) treatment were recruited, including 60 PCOS patients (PCOS non MS and PCOS MS) and 30 age-matched controls. Individual FF samples were analyzed using the cytometric multiplex immunoassay. Results: In the FF, the PCOS MS group was associated with higher, total cholesterol (TC), triglyceride (TG) and lower high-density lipoprotein (HDL) concentrations compared with that in the control group (P < 0.05). The FF tumor necrosis factor-alpha (TNF-alpha) level in the PCOS MS group was 3.89 +/- 1.18 ng/mL, which was significantly higher compared with the control (2.94 +/- 1.02 ng/mL) and PCOS non-MS groups (3.05 +/- 1.21 ng/mL) (P = 0.002), while the granulocyte colony-stimulating factor (G-CSF) level in the PCOS MS group (4.18 +/- 1.33 ng/mL) was lower compared with the control (5.61 +/- 1.82 ng/mL) and PCOS non MS groups (5.32 +/- 1.91 ng/mL) (P = 0.004). The FF G-CSF showed a trend toward negative relationship with TG and TC; TNF-alpha concentration was positively associated with TG. The percentage of top-quality embryo decreased in the PCOS MS group than in the other two groups (20% vs. 38.4% and 34.6%). Conclusions: In conclusion, there was an elevated lipolysis condition within the FF of PCOS MS patients and the TNF-alpha and G-CSF levels in FF were associated with top-quality embryo percentage. TNF-alpha and G-CSF may be the key cytokines involved in the mechanism of decreased embryo development potential in PCOS MS patients. (C) 2017 Elsevier Ltd. All rights reserved.