Metabolic Hormones in Follicular Fluid in Women Undergoing in Vitro Fertilization

OBJECTIVE: To determine the concentrations of metabolic hormones in follicular fluid (FF) and to find clinical correlates of these biochemical parameters. STUDY DESIGN: FF was obtained from 108 women by ultrasonography-guided transvaginal puncture following controlled ovarian hyperstimulation. FF insulin, leptin, adiponectin and resistin levels were measured by enzyme-linked immunosorbent assay, and ghrelin was analyzed with radioimmunoassay. RESULTS: It was demonstrated that oocyte number correlated negatively with FF leptin (r =-0.190, p <0.050) and insulin (r = 0.209, p <0.031) and positively with resistin (r = 0.236, p <0.014). After adjustments for confounding hormone parameters, resistin remained a positive (p <0.000) predictor and insulin (p <0.039) and adiponectin (p <0.033), negative predictors of oocyte number. When the embryo number was considered, FF leptin. proved to be a strong negative (p < 0.012) whereas resistin proved to be a positive outcome predictor (p <0.004). CONCLUSION: In women undergoing in vitro fertilization (IVF), FF metabolic hormones may be involved in regulating ovarian function and in determining fertilization outcome. Resistin appears to have beneficial effects on the outcome of IVF, while leptin, insulin, adiponectin and ghrelin appear to have adverse or no effects.