Assessment of follicular fluid leptin levels and insulin resistance as outcome predictors in women undergoing in vitro fertilization intracytoplasmic sperm injection

Capsule:
High follicular fluid leptin levels were associated with a lower probability of live birth in women undergoing in vitro fertilization–intracytoplasmic sperm injection. Serum progesterone, follicle number, and leptin levels seem to predict IVF outcome.

Authors:
David Llaneza-Suarez, Ph.D., Placido Llaneza, M.D., Celestino Gonzalez, Ph.D., M.D., Pedro De-la-Fuente, M.D., Carlos Garcia-Ochoa, M.D., Pablo Garrido, Ph.D., Vanesa Castañon, Ph.D., Faustino Perez-Lopez, Ph.D., M.D.

Volume 102, Issue 6, Pages 1619-1625

Abstract:

Objective:
To analyze follicular fluid leptin (FFL) levels, abdominal obesity, and insulin resistance as predictors of in vitro fertilization (IVF)–intracytoplasmic sperm injection (ICSI) outcome.

Design:
Observational study.

Setting:
Academic medical center.

Patient(s):
A sample of 130 infertile women aged 26–40 years without polycystic ovary syndrome.

Intervention(s):
Measurement of FFL levels in controlled ovarian hyperstimulation cycles with an antagonist and agonist protocol for IVF-ICSI.

Main Outcome Measure(s):
Live birth rate.

Result(s):
Mean FFL values were significantly higher in pregnancies not ending in a live birth, even after adjustment for waist circumference and insulin resistance. A multivariable model obtained with the use of logistic binary regression analysis showed that waist circumference and insulin resistance had no influence over IVF-ICSI outcomes, but a higher number of follicles, lower serum progesterone levels on the day before α-hCG administration, and lower FFL concentrations were significantly associated with a higher probability of having a live birth. The multivariate model reached a sensitivity of 87% and a specificity of 71% for predicting the possibility of pregnancy ending in a live birth.

Conclusion(s):
High FFL levels were associated with abdominal obesity, insulin resistance, and a lower live birth rate after IVF-ICSI. Further investigations are warranted to define the precise roles of leptin, obesity, and insulin resistance on IVF-ICSI outcomes.

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