Increased levels of prostaglandin E and F2 alpha suggest a pro-inflammatory environment in follicular fluid obtained from low-responder patients¡±

DANIELA COLACI; IGNACIO DE ZUÑIGA; M HORTON; MONICA FAUT; F SOBRAL; M GOMEZ PEÑA; ALICIA BEATRIZ MOTTA

Roma, Italia

Congreso; ESHRE 2010, 27th Annual Meeting of the European Society of Human Reproduction & Embryology, Roma 2010; 2010

European Society of Human Reproduction & Embryology

Introduction: Although assisted reproductive technology has improved dramatically in the last decades, reproductive outcomes in low-responder patients remain unsatisfactory. Different elements of the follicular fluid had been studied in an attempted to find markers that improve our understanding of follicular dynamics in these patients. The production of reactive oxygen species (superoxide radical, hydrogen peroxide, hydroxyl radical, etc) is a well known physiological process in all cells. However, the accumulation of oxygen species is a consequence of the uncontrolled lipid peroxidation (LPO) of cellular membranes. Protection against oxidative stress is provided by different enzymes such as the superoxide dismutase, diverse metabolites as the glutathione, or vitamins. The imbalance between the oxidant and the antioxidant processes is known as oxidative stress and generates cell damage. The oxidative and inflammatory environment may impair follicular function in low-responder patients. The aim of our study was to evaluate oxidative stress and inflammatory markers in follicular fluid from low- responder patients. Material & methods: Follicular fluid (FF) was obtained from 30 infertile women undergoing transvaginal oocyte retrieval with ultrasound guidance. Fifteen low-responder patients (LR) were in the study group. LR was defined according to the following criteria: ¡Ü5 oocytes retrieved or previous IVF cycles cancelled due to a small number of follicles developed. Control group was composed by 15 infertile women undergoing IVF/ICSI due to male factor, tubal factor (patients with endometriosis were excluded) or sterility without a cause. Oxidative stress was assessed by quantifying LPO and antioxidant defenses were evaluated by measuring glutathione and superoxide dismutase activity. In addition, prostaglandin (PG) E and prostaglandin F2 alpha were also quantified in all the samples. LPO and antioxidants were measured using specific espectrophotometric assays and PGs using specific radioimmuno assays. Results: LPO levels in LR patients were lower than in controls (0.028¡À0.007 vs. 0.045¡À0.017 nmol/mg protein respectively). There were no differences in the antioxidant defenses between the two groups. Superoxide dismutase activity was 0.070¡À0.010 IU/mg protein in LR and 0.051¡À0.0310 IU/mg protein in controls. Additionally, glutathione concentration was 0.004¡À0.0010 umol/mg protein in LR and 0.0039¡À0.001 umol/mg in controls. Both PGs were significantly increased in LR patients (PGE= 27¡À10 pg/mg protein and PGF2alpha= 7.5¡À0.3 pg/mg protein) compared to controls (PGE= 0.54¡À0.3 and PGF2alpha= 2.9¡À0.7 pg/mg protein). Conclusion: Our results indicate that follicular fluid obtained from low-responder patients shows a remarkable pro-inflammatory status. This may represent the intra-follicular cells response to an adverse ovarian environment. Since PGE is a precursor of PGF2alpha, the relationship that we found between these two PGs suggests a large inflammatory atmosphere. We did not find a pro-oxydant activity, nevertheless; we encourage this line of study as many diverse reactive oxygen species should be determined before we can make a robust conclusion regarding oxidant activity in low-responder patients.