The effect of oxidative stress in follicular fluid on the outcome of IVF

Objective(s): To investigate the relationship between oxidative stress parameters in follicular fluids and IVF outcomesDesign: Prospective studySetting: Tertiary care medical centerMethods: The levels of follicular fluid malondialdehyde (MDA), protein carbonyl and nitric oxide (NO) were measured spectrophotometrically.Results: Totally 249 follicular fluids and their oocytes from 76 patients were enrolled in to the study. The follicular fluid MDA levels were significantly higher; in follicles whose oocytes have successfully fertilized compared with non-fertilized oocytes (6, 37±0, 57 vs 3, 70±0, 33 µmol/L, P=0,022). The mean concentration of NO was significantly lower (40, 12 ±1, 49 vs 45, 50 ±1, 21 nmol NO/mg protein, P=0,006) and protein carbonyl was significantly higher (16, 91± 1, 85 vs 13, 45 ±0, 58 nmol/ml, P=0,045) in follicular fluids whose oocytes developed to the top quality embryos. The levels of MDA in follicular fluids belong to the patients with PCOS were significantly higher compared with the others (10,50±1,96 vs 4,99±0,28 µmol/L, P<0.001). The follicular fluids of poor and hyperresponders had significantly lower levels of MDA and significantly higher levels of NO compared with normal responders. The mean follicular fluid MDA concentrations of patients who successfully conceived were significantly higher than follicular fluids of non-conceived patients (7,18±0,79 vs 4.70±0,60 µmol/L, P=0,005).Conclusion(s): Lipid peroxidation seems to be related with fertilization and pregnancy. The higher levels of NO in follicular fluid adversely effect embryo quality. As the number of oocytes yielded increases, lipid peroxidation decreases and NO concentration increases. These investigated oxidative stress markers in follicular fluid may be beneficial to predict the IVF outcomes.