Estradiol and leptin as conditional prognostic IVF markers

Abstract

We studied the concentration of serum estradiol and serum and follicular fluid leptin in 200 women undergoing their first in vitro fertilization with embryo transfer (IVF-ET) program at the time of human chorionic gonadotrophin administration and oocyte retrieval, in an attempt to assess their concerted role on embryo quality and the prognosis of IVF outcome. Low serum (46.49 6 8.4 ng/ml) and follicular fluid (52 6 9.8 ng/ml) leptin levels were associated with a high number of 'good-quality' embryos (73.6%) and high implantation (11.2%) and pregnancy (35.8%) rates and were observed in women with normal peak estradiol levels of between 1000 and 2000 pg/ml. It appears that leptin and estradiol interact coordinately in a concentration-dependent manner to control IVF outcome. Further studies will be required to substantiate and clarify the mechanism of proposed conditional interaction between the two hormonal systems.

Serum and follicular fluid leptin levels are correlated with human embryo quality

“…This lack of correlation suggested that estradiol and leptin might have opposing roles during ovarian stimulation. Their parallel, although disproportional, elevation on the day of hCG administration, however, has been shown to have a negative influence on IVF-ET outcome, in agreement with our recent report (Anifandis et al 2005).…”

“…3), a finding common to all samples from ART success (positive b-hCG test, pregnant) and failure women (negative b-hCG test, non-pregnant) ( Table 1). The observed variation in leptin but not BMI of women categorized either according to estradiol levels on hCG administration day (Anifandis et al 2005) or ART success/failure women (BMI of ART success women, 21.16^0.88 kg/m 2 and BMI of ART failure women, 23.14^0.85 kg/m 2 , P ¼ not significant) suggests that the relative sensitivities of these two parameters differ with leptin being a far more sensitive IVF marker compared with BMI. In agreement with the leptin levels and in contrast to BMI, embryo quality differed significantly between the two groups being of far superior quality in ART success women (58% vs 32%, P , 0.01) ( Table 1).…”

“…We have recently presented correlational evidence demonstrating the conditional role of leptin and estradiol as prognostic IVF markers potentially regulating embryo quality (Anifandis et al 2005). In view of the important, although in many aspects still controversial role of leptin in ART, we undertook to reassess the prognostic value of its fluctuations during critical stages of the IVF process and to address its potential role as a direct functional staging (Nomikos & Vamvakopoulos 2001) marker of ART at the level of embryo quality.…”

The utility of serum leptin and follicular fluid leptin, estradiol, and progesterone levels during an in vitro fertilization cycle

“…Some prior studies have found a negative correlation with leptin levels and IVF outcomes [10][11][12][13]. The primary difference with our study compared to previous studies was the number of data points for collected leptin samples.…”

“…Some studies have shown no correlation of follicular fluid or serum leptin with IVF outcome or sex-steroid levels [8,9]. This is in contrast to other studies which found that low serum and follicular fluid levels of leptin negatively correlated with embryo quality, implantation rates, and pregnancy rates [10][11][12][13]. Follicular fluid concentrations of leptin, estradiol, and progesterone have been evaluated by few studies [10][11][12][13].…”