Obesity and follicular fluid oxidative stress: Relationship to ICSI outcome

Abstract

Objective To study the influence of female obesity on follicular fluid oxidative stress and to correlate it to intracytoplasmic sperm injection (ICSI) outcome. Study design Seventy-four normal females below the age of 40 undergoing ICSI for reason of male factor infertility were enrolled in the study. They were divided into 2 groups according to body mass index (BMI); Group I (non-obese) (n = 24, BMI < 25 Kg/m2) and Group II (obese) (n = 50, BMI ≥ 25 Kg/m2). Oxidative stress markers (MDA (malonaldehyde), NO2/NO3 (Nitrite/Nitrate) ratio, GSH (reduced glutathione) and GSH/GSSG (reduced glutathione/oxidized glutathione) ratio) were measured by high performance liquid chromatography (HPLC). Results Obese women had significantly higher mean follicular fluid MDA (P = 0.006) as well as NO 2/NO3 ratio (P = 0.004). BMI strongly correlated to follicular fluid MDA (P = < 0.01). MDA showed strong positive correlation to NO2/NO3 ratio (P = 0.02). GSH and GSH/GSSG ratio showed a non-significant difference between the two groups (P = 0.14 and 0.67, respectively). Clinical pregnancy rate was significantly higher in the non-obese group (87%) compared to the obese (43%) (P = <0.01, OR:13; 95% CI 3.54-52). With binary logistic regression, MDA was found to be a good predictor of the occurrence of pregnancy (P = <0.01). No significant differences were detected as regards parameters including estradiol on day of hCG, gonadotropin dose, number of retrieved oocytes, metaphase II(MII) and fertilized oocytes. Conclusion Obesity aggravates follicular fluid oxidative stress with a negative impact on pregnancy outcome of ICSI cycles. © 2013 Production and hosting by Elsevier B.V.