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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2017, Vol. 11 Issue (2) : 247-252     DOI: 10.1007/s11684-017-0519-6
RESEARCH ARTICLE |
Free radical scavenging window of infertile patients with polycystic ovary syndrome: correlation with embryo quality
Bo Huang, Zhou Li, Xinling Ren, Jihui Ai, Lixia Zhu(), Lei Jin()
Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Abstract  

The activity of free radicals in follicular fluid was related to ovarian responsiveness, in vitro fertilization (IVF), and embryo transfer success rate. However, studies analyzing the relationship between the free radical scavenging capacity and embryo quality of infertile women with polycystic ovarian syndrome (PCOS) were lacking. The aim of this study was to evaluate the relationship between the free radical scavenging window of women with PCOS and their embryo quality. The free radical scavenging capacity of follicular fluid from women with PCOS was determined by a,a-diphenyl-b-picrylhydrazyl (DPPH), 2,2-azinobis (3-ethylbenzthiazoline-6-sulphonic acid) assay, superoxide radical, and reactive oxygen species (ROS) assay. In the DPPH and ROS assays, the follicular fluid from grades I and II embryos was significantly higher than the follicular fluid from grades III and IV embryos. The lower control limit of DPPH radical scavenging capacity and upper control limit of ROS level were 13.2% and 109.0 cps, respectively. The calculated lower control limit and upper control limit were further confirmed in the follicular fluid of embryos of all grades. These cut-off values of free radical scavenging activity of follicular fluid could assist embryologists in choosing the development of embryos in PCOS patients undergoing IVF.

Keywords in vitro fertilization      PCOS      free radical      embryo quality     
Corresponding Authors: Lixia Zhu,Lei Jin   
Just Accepted Date: 14 April 2017   Online First Date: 08 May 2017    Issue Date: 01 June 2017
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-017-0519-6     OR     http://academic.hep.com.cn/fmd/EN/Y2017/V11/I2/247
Fig.1  The free radical scavenging capacity of infertile women with PCOS: the correlation with embryo quality. (A) DPPH radical scavenging assay; (B) ABTS radical scavenging assay; (C) ROS levels assay. Grades I and II group, n=294; Grades III and IV group, n=108. Different letters differed significantly ((A) P = 0.045, (C) P =0.002).
Embryo qualityKb value ( × 10-4)Sig.
Grades I and II embryos13.52±0.39P>0.05
Grades III and IV embryos14.33±0.51
Tab.1  The correlation between superoxide radical scavenging capacity in follicular fluid of infertile women undergoing IVF and their embryo quality
Fig.2  The control chart of lower control limit of DPPH radical scavenging capacity and upper control limit of ROS level in follicular fluid from women with PCOS. (A) lower control limit of DPPH radical scavenging capacity; (B) upper control limit of ROS level.
Cut-off levelGrades I and II embryo formation (%)Sig.
DPPH radical scavenging ability (%)>13.2 (391)74.4% (291/391)P<0.01
<13.2 (11)36.4% (4/11)
ROS level (cps)<109.0 (389)74.6% (290/389)P<0.001
>109.0 (13)30.8% (4/13)
Tab.2  Identification of the correlation between cut-off level in radical scavenging capacity of follicular fluid from infertile women and their embryo quality
1 Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, Azziz R. Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study. J Clin Endocrinol Metab 1998; 83: 3078–3082
2 Carmina E, Campagna AM, Lobo RA. Emergence of ovulatory cycles with aging in women with polycystic ovary syndrome (PCOS) alters the trajectory of cardiovascular and metabolic risk factors. Hum Reprod 2013; 28(8): 2245–2252
doi: 10.1093/humrep/det119
3 Layegh P, Mousavi Z, Farrokh Tehrani D, Parizadeh SM, Khajedaluee M. Insulin resistance and endocrine-metabolic abnormalities in polycystic ovarian syndrome: comparison between obese and non-obese PCOS patients. Int J Reprod Biomed (Yazd) 2016; 14: 263–270
4 Mikola M, Hiilesmaa V, Halttunen M, Suhonen L, Tiitinen A. Obstetric outcome in women with polycystic ovarian syndrome. Hum Reprod 2001; 16(2): 226–229
doi: 10.1093/humrep/16.2.226
5 Boomsma CM, Eijkemans MJ, Hughes EG, Visser GH, Fauser BC, Macklon NS. A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome. Hum Reprod Update 2006; 12(6): 673–683
doi: 10.1093/humupd/dml036
6 Sabuncu T, Vural H, Harma M, Harma M. Oxidative stress in polycystic ovary syndrome and its contribution to the risk of cardiovascular disease. Clin Biochem 2001; 34(5): 407–413
doi: 10.1016/S0009-9120(01)00245-4
7 Hilali N, Vural M, Camuzcuoglu H, Camuzcuoglu A, Aksoy N. Increased prolidase activity and oxidative stress in PCOS. Clin Endocrinol (Oxf) 2013; 79(1): 105–110
doi: 10.1111/cen.12110
8 Xiao JS, Su CM, Zeng XT. Comparisons of GnRH antagonist versus GnRH agonist protocol in supposed normal ovarian responders undergoing IVF: a systematic review and meta-analysis. PLoS One 2014; 9(9): e106854
doi: 10.1371/journal.pone.0106854
9 Mahmoud Youssef MA, van Wely M, Aboulfoutouh I, El-Khyat W, van der Veen F, Al-Inany H. Is there a place for corifollitropin α in IVF/ICSI cycles? A systematic review and meta-analysis. Fertil Steril 2012; 97(4): 876–885
doi: 10.1016/j.fertnstert.2012.01.092
10 Palini S, Benedetti S, Tagliamonte MC, De Stefani S, Primiterra M, Polli V, Rocchi P, Catalani S, Battistelli S, Canestrari F, Bulletti C. Influence of ovarian stimulation for IVF/ICSI on the antioxidant defence system and relationship to outcome. Reprod Biomed Online 2014; 29(1): 65–71
doi: 10.1016/j.rbmo.2014.03.010
11 Yen M, Donma O, Yildizfer F, Ekmekci O, Asli Karatas Kul Z, Esat Imal A, Keser Z, Cagil E, Mengi M, Ekmekci H, Sahmay S, Donma M. Association of fetuin A, adiponectin, interleukin 10 and total antioxidant capacity with IVF outcomes. Iran J Reprod Med 2014; 12: 747–754
12 Arya BK, Haq AU, Chaudhury K. Oocyte quality reflected by follicular fluid analysis in poly cystic ovary syndrome (PCOS): a hypothesis based on intermediates of energy metabolism. Med Hypotheses 2012; 78(4): 475–478
doi: 10.1016/j.mehy.2012.01.009
13 Yilmaz N, Inal HA, Gorkem U, Sargin Oruc A, Yilmaz S, Turkkani A. Follicular fluid total antioxidant capacity levels in PCOS. J Obstet Gynaecol 2016; 36(5): 654–657
doi: 10.3109/01443615.2016.1148683
14 Nuñez-Calonge R, Cortes S, Gutierrez Gonzalez LM, Kireev R, Vara E, Ortega L, Caballero P, Rancan L, Tresguerres J. Oxidative stress in follicular fluid of young women with low response compared with fertile oocyte donors. Reprod Biomed Online 2016; 32(4): 446–456
doi: 10.1016/j.rbmo.2015.12.010
15 Aydin Y, Ozatik O, Hassa H, Ulusoy D, Ogut S, Sahin F. Relationship between oxidative stress and clinical pregnancy in assisted reproductive technology treatment cycles. J Assist Reprod Genet 2013; 30(6): 765–772
doi: 10.1007/s10815-013-0005-2
16 Aydin Y, Hassa H, Oge T, Tokgoz VY. A randomized study of simultaneous hCG administration with intrauterine insemination in stimulated cycles. Eur J Obstet Gynecol Reprod Biol 2013; 170(2): 444–448
doi: 10.1016/j.ejogrb.2013.07.022
17 Carbone MC, Tatone C, Delle Monache S, Marci R, Caserta D, Colonna R, Amicarelli F. Antioxidant enzymatic defences in human follicular fluid: characterization and age-dependent changes. Mol Hum Reprod 2003; 9(11): 639–643
doi: 10.1093/molehr/gag090
18 Lambrinoudaki IV, Augoulea A, Christodoulakos GE, Economou EV, Kaparos G, Kontoravdis A, Papadias C, Creatsas G. Measurable serum markers of oxidative stress response in women with endometriosis. Fertil Steril 2009; 91(1): 46–50
doi: 10.1016/j.fertnstert.2007.11.021
19 Özkaya  MO, Naziroglu M. Multivitamin and mineral supplementation modulates oxidative stress and antioxidant vitamin levels in serum and follicular fluid of women undergoing in vitro fertilization. Fertil Steril 2010; 94(6): 2465–2466
doi: 10.1016/j.fertnstert.2010.01.066
20 Campospetean C, Ferriani R, Dosreis R, Diasdemoura M, Jordao A Jr, Andreadealbuquerquesallesnava P. Lipid peroxidation and vitamin E in serum and follicular fluid of infertile women with peritoneal endometriosis submitted to controlled ovarian hyperstimulation: a pilot study. Fertil Steril 2008; 90(6): 2080–2085
doi: 10.1016/j.fertnstert.2007.10.072
21 Wiener-Megnazi Z, Vardi L, Lissak A, Shnizer S, Zeev Reznick A, Ishai D, Lahav-Baratz S, Shiloh H, Koifman M, Dirnfeld M. Oxidative stress indices in follicular fluid as measured by  the thermochemiluminescence assay correlate with outcome parameters in in vitro fertilization. Fertil Steril 2004; 82(Suppl 3): 1171–1176
doi: 10.1016/j.fertnstert.2004.06.013
22 Huang B, Qian K, Li Z, Yue J, Yang W, Zhu G , Zhang H. Neonatal outcomes after early rescue intracytoplasmic sperm injection: an analysis of a 5-year period. Fertil Steril 2015;103(6):1432–1437.e1
23 Huang B, Ren X, Wu L, Zhu L, Xu B, Li Y, Ai J, Jin L. Elevated progesterone levels on the day of oocyte maturation may affect top quality embryo IVF cycles. PLoS One 2016; 11(1): e0145895
doi: 10.1371/journal.pone.0145895
24 Huang B, Li Z, Ai J, Zhu L, Li Y, Jin L, Zhang H. Antioxidant capacity of follicular fluid from patients undergoing in vitrofertilization. Int J Clin Exp Pathol 2014; 7(5): 2273–2282
25 Huang B, Hu D, Qian K, Ai JH, Li YF, Jin L, Zhu  G, Zhang HW. Is frozen embryo transfer cycle associated with a significantly lower incidence of ectopic pregnancy? An analysis of more than 30,000 cycles. Fertil Steril 2014; 102 (5): 1345–1349
26 Huang B, Li Z, Zhu L, Hu D, Liu Q, Zhu G, Zhang H. Progesterone elevation on the day of HCG administration may affect rescue ICSI. Reprod Biomed Online 2014; 29(1): 88–93
doi: 10.1016/j.rbmo.2014.03.015
27 Huang B, Yang F, Dong X, Zheng Y, Tan H, Ai J, Jin L. Lower limit of antioxidant activity in follicular fluid: relationship to embryo quality in IVF cycle. Int J Clin Exp Med 2016; 9: 16346–16352
28 Huang B, Ke H, He J, Ban X, Zeng H, Wang Y. Extracts of Halenia elliptica exhibit antioxidant properties in vitro and in vivo. Food Chem Toxicol 2011; 49(1): 185–190
doi: 10.1016/j.fct.2010.10.015
29 Jana SK, K NB, K NB, Chattopadhyay R, Chakravarty B, Chaudhury K. Upper control limit of reactive oxygen species in follicular fluid beyond which viable embryo formation is not favorable. Reprod Toxicol 2010; 29(4): 447–451
doi: 10.1016/j.reprotox.2010.04.002
30 Veeck LL. An atlas of human gametes and conceptuses: an illustrated reference for assisted reproductive technology. New York: Parthenon Publishing, 1999
31 Kuşçu NK, Var A. Oxidative stress but not endothelial dysfunction exists in non-obese, young group of patients with polycystic ovary syndrome. Acta Obstet Gynecol Scand 2009; 88(5): 612–617
doi: 10.1080/00016340902859315
32 Ismail AM, Hamed AH, Saso S, Thabet HH. Adding L-carnitine to clomiphene resistant PCOS women improves the quality of ovulation and the pregnancy rate. A randomized clinical trial. Eur J Obstet Gynecol Reprod Biol 2014; 180: 148–152
doi: 10.1016/j.ejogrb.2014.06.008
33 Fulghesu AM, Ciampelli M, Muzj G, Belosi C, Selvaggi L, Ayala GF, Lanzone A. N-acetyl-cysteine treatment improves insulin sensitivity in women with polycystic ovary syndrome. Fertil Steril 2002; 77(6): 1128–1135
doi: 10.1016/S0015-0282(02)03133-3
34 Dikmen A, Ergenoglu AM, Yeniel AO, Dilsiz OY, Ercan G, Yilmaz H. Evaluation of glycemic and oxidative/antioxidative status in the estradiol valerate-induced PCOS model of rats. Eur J Obstet Gynecol Reprod Biol 2012; 160(1): 55–59
doi: 10.1016/j.ejogrb.2011.09.042
35 Paszkowski T, Clarke RN. Antioxidative capacity of preimplantation embryo culture medium declines following the incubation of poor quality embryos. Hum Reprod 1996; 11(11): 2493–2495
doi: 10.1093/oxfordjournals.humrep.a019146
36 Yang HW, Hwang KJ, Kwon HC, Kim HS, Choi KW, Oh KS. Detection of reactive oxygen species (ROS) and apoptosis in human fragmented embryos. Hum Reprod 1998; 13(4): 998–1002
doi: 10.1093/humrep/13.4.998
[1] Gang WANG. NADPH oxidase and reactive oxygen species as signaling molecules in carcinogenesis[J]. Front Med Chin, 2009, 3(1): 1-7.
[2] HE Zhongye, GUO Renxuan, LI Yang, XIE Chengyao, LIU Nan, SONG Wen. Alleviation of cell damage in experimental ANP in rats by administration of chondroitin-sulfate reduces[J]. Front. Med., 2007, 1(1): 36-40.
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