The role of fatty acids on ICSI outcomes: a prospective cohort study

Abstract

BackgroundOur objective was to determine the effect of fatty acids (FAs) in serum and follicular fluid (FF) on fertilization and intracytoplasmic sperm injection (ICSI) outcomes.MethodsOne hundred five women aged 18–38 years undergoing ICSI were recruited in this prospective cohort study. oocyte and emberyo quality was morphologically assessed. FAs in serum and FF were analyzed, using gas chromatography–mass spectrometry (GC-MS).ResultsThe mean number of mature oocytes was associated with serum levels of oleic acid (r = 0.58; P = 0.002). There were negative correlations between metaphase II oocytes and FF levels of stearic acid (r = −0.19; P = 0.04) and linolenic acid (r = −0.37; P = 0.004). According to the obtained Spearman’s correlation coefficients, serum levels of stearic, palmitoleic and tricosanoic acids were positively correlated with the percent of germinal vesicle (GV) stage oocyte.The mean serum level of eicosapentaenoic acid was significantly higher in pregnant women than in non-pregnant patients (P = 0.006). Good quality embryos’ percentages were negatively correlated with the concentrations of palmitic acid (r = −0.22; P = 0.02).After adjusting the effects of body mass index and age, total FAs were found to have a significant effect on the odds of having high-quality oocytes (percentage of oocytes > 80%; odds ratio =2.55; P = 0.054).ConclusionParticular FAs affect oocyte maturation and implantation. Apparently, while higher FF levels of saturated FAs, especially palmitic and stearic acids, observed in some metabolic contexts have harmful effects on oocyte maturation and implantation, such effects can be counteracted and developmental competence can be enhanced (at least in vitro) by the presence of unsaturated FAs, e.g. oleic and eicosapentaenoic acids.

Diet and female fertility: doctor, what should I eat?

“…The EARTH study reported that for every 1% increase in serum long-chain u-3 PUFA levels, the probability of clinical pregnancy and live birth increased by 8% (102). In another study, serum levels of eicosapentaenoic acid (a long-chain u-3 PUFA) were significantly higher in pregnant than in nonpregnant patients (103). In addition, higher preconception u-3 PUFA intake was associated with better embryo morphology, despite being inversely associated with response to ovarian stimulation (104).…”

Omega-3 polyunsaturated fatty acids and IVF treatment

“…No correlation between omega-3 PUFA index and IVF outcomes, such as number of oocytes retrieved, embryo grade or clinical pregnancy, was found in another small study (n = 60) (Eskew et al, 2017). Mirabi et al (2017) measured serum and follicular fluid level of fatty acids in 105 women undergoing IVF. They found that EPA levels were significantly higher in pregnant than non-pregnant women (P = 0.006), and following adjustment for age and body mass index (BMI), total fatty acids was correlated with highquality oocytes.…”

“…No correlation between omega-3 PUFA index and IVF outcomes. Mirabi et al, 2017), Iran 105 Serum level of fatty acid Yes EPA serum level was significantly higher in pregnant women. Chiu et al, 2018, USA 100 Serum level of fatty acid on days 3-9 of stimulation Yes High levels of total omega-3 PUFAs and EPA are associated with higher probability of pregnancy and live birth.…”

“…It is unclear why studies in IVF have yielded conflicting results on the relationship between PUFA intake and IVF outcomes, but it may be due, in part, to the combination of a small number of cycles in each study and the variability of studies. In total, five studies (556 cycles) reported a clinical outcome of IVF: two studies showed a positive effect of omega-3 PUFAs, especially EPA, on clinical pregnancy (Mirabi et al, 2017;Chiu et al, 2018), one found no correlation (Eskew et al, 2017), and one found a negative effect of ALA (Jungheim et al, 2011); however, in a larger follow-up study from the same group, no detrimental effect was found nor was a correlation found between PUFAs and the chance of becoming pregnant, although a higher ratio of linoleic acid-ALA increased this chance (Jungheim et al, 2013). Marked differences exist between the studies.…”

“…Marked differences exist between the studies. For example, time of blood sampling ranged from days 3-9 of stimulation (Chiu et al, 2018), day 8 (Eskew et al, 2017), day of oocyte retrieval (Jungheim et al, 2013) or was not specified (Mirabi et al, 2017). Differences in patient characteristics were present between studies, e.g., in BMI (27.7 versus 24.4 kg/m 2 ) (Jungheim et al, 2013;Chiu et al, 2018), and analytical approaches also differed, especially for assessment of linoleic acid-ALA ratios (Chiu et al, 2018).…”