Oocyte cytoplasmic immaturity is related to metaphase plate anomalies and aneuploidies. Fertilized oocytes, from a cohort with sub optimal fertilization with cytoplasmic immaturity, had poorer reproductive outcomes.
Recommended reporting items are underused in top infertility journals, which could lead to misleading interpretations. Authors, reviewers, and editorial boards should emphasize their use to improve reporting quality.
OBJECTIVE: Studies suggest lysophosphatidic acid (LPA) may influence ovarian folliculogenesis, but the clinical significance is largely unknown. Thus we investigated associations between LPA species in ovarian follicular fluid (FF) and important clinical parameters in women undergoing in vitro fertilization (IVF).DESIGN: Cross-sectional. MATERIALS AND METHODS: FF was collected from women ages 18-44 during oocyte retrieval for IVF. Women using gestational carriers or whose cycles were cancelled were excluded. FF LPA species were quantified by liquid chromatography-mass spectroscopy. Clinical parameters investigated included patient age, body mass index (BMI), infertility diagnosis, antral follicle count, length of controlled ovarian hyperstimulation (COH) required to achieve mature follicle size, number of oocytes retrieved, percent mature oocytes, oocyte fertilization rate, and percent good quality cleavage stage embryos. Associations between LPA species and clinical parameters were made using appropriate bivariate statistics and stratified analysis.RESULTS: 197 women were included. A negative correlation was noted between amounts of FF LPA (C14:0, C16:0, and C18:0 species) and duration of COH (r¼-.2, r¼-.2, r¼-.2 respectively, p< .002 for all), whereas a positive correlation was noted between FF LPA and BMI (r¼.22, r¼.3, r¼.3 respectively, p< .002 for all). FF LPA species were not associated with any other variables. Women were stratified by BMI into normal (BMI <25kg/m2, n¼144) and obese (R30 kg/m2, n¼56) groups. Looking again at the correlation between FF LPA and duration of stimulation it was only significant among obese women (r¼-.4, r¼-.4, r¼-.4, p<0.02), but not among women of normal BMI.CONCLUSIONS: Historically obesity has been associated with a longer duration of stimulation in COH. Our data demonstrate that FF LPA levels increase with obesity but that lower levels in obese women are associated with longer duration of COH to achieve mature ovarian follicles. This data suggests some LPA species may confer a benefit in folliculogenesis for obese women undergoing COH.
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