Serum and Follicular Fluid Leptin during in Vitro Fertilization: Relationship among Leptin Increase, Body Fat Mass, and Reduced Ovarian Response
The satiety factor leptin is expressed in several reproductive tissues, but its role in the control of reproductive physiology is not well understood. We studied leptin concentrations in the sera and follicle fluids of 52 women [body fat mass percentage (BFM%) range, 19.6–38.8%] undergoing pituitary...
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Veröffentlicht in: | The journal of clinical endocrinology and metabolism 1999, Vol.84 (9), p.3135-3139 |
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Zusammenfassung: | The satiety factor leptin is expressed in several reproductive tissues,
but its role in the control of reproductive physiology is not well
understood. We studied leptin concentrations in the sera and follicle
fluids of 52 women [body fat mass percentage (BFM%) range,
19.6–38.8%] undergoing pituitary down-regulation and ovarian
hyperstimulation for in vitro fertilization (IVF)
treatment. Fasting serum samples were collected 1) at maximal
suppression before the initiation of gonadotropin treatment, 2) at
maximal ovarian hyperstimulation, 3) at the time of oocyte retrieval,
and 4) 16 days later when all subjects were under exogenous luteal
support using 600 mg progesterone daily. Follicular fluid (FF) was
obtained at oocyte retrieval from two representative preovulatory
follicles in both ovaries. During ovarian hyperstimulation there was a
significant 60% increase in serum leptin concentrations from 10.9±
1.1 (sem) to 15.7 ± 1.5 ng/mL
(P < 0.01) between suppression and maximal
hyperstimulation, demonstrating that the ovarian functional state can
affect serum leptin concentrations. A serum leptin increase of
22–198% during ovarian hyperstimulation was evident in 43 subjects,
whereas in 9, leptin concentrations remained unchanged. A positive
correlation between leptin change and BFM% (r = 0.55;
P < 0.0005) was observed in the 43 leptin
responders. The follicular fluid leptin level was similar to that in
serum. In separate linear regression analysis, BFM% contributed to
59–64%, body mass index to 46–56%, and weight to 46–55% (all
P < 0.001) of the variability in leptin
concentrations at the 4 time points. The 20-fold increase in serum
estradiol concentrations during IVF was not significantly correlated
with changes in leptin concentrations. On the contrary, the relative
serum leptin increase was negatively associated with the ovarian
response to hyperstimulation, as revealed by the numbers of follicles
(b = −0.28; r2 = 8.1%; P< 0.05) and oocytes retrieved (b = −0.39; r2 =
15.2%; P < 0.01). This relationship was further
reflected in a positive correlation between the percent increases in
leptin and FSH concentrations (r = 0.39; P <
0.01). The significant relationship of high leptin and reduced ovarian
response was also maintained when the cumulative dose of FSH was used
as a covariable. Reduced ovarian response was not a function of body
mass index, BFM%, basal leptin levels, or insulin concentrations.
Fasting serum insulin concentrations remained unchanged in re |
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ISSN: | 0021-972X 1945-7197 |
DOI: | 10.1210/jcem.84.9.6004 |