P-95: Influences of Metabolic and Nutritional Status on IVF Outcomes

Background: The aim of our study was to determine the metabolic profile: glucose, triglycerides (TG), high density lipoprotein (HDL) and cholesterol (CHT) in women undergoing ART (Assisted reproductive technology) cycles and estimate its effect on In Vitro Fertilization (IVF) outcomes Materials and Methods: Forty three women undergoing IVF treatment were included in the study. Patients were allocated into three groups according to body mass index (BMI), normal weight, overweight and obese. Blood samples were collected at the time of ovum pick up to determine metabolic profile. Higher levels of TG in obese women is negatively correlated with embryo quality and fertilization rate (p=0.032 and p=0.0196). CHT levels are also negatively correlated with oocyte maturity and quality. Sperm and oocytes preparation techniques for intracytoplasmic sperm injection and evaluation of embryo quality were interpreted according to WHO criteria. Results: Dyslipidemia is the responsible for impaired oocyte quality by the increased production of reactive oxygen species unfavorable to the development of preimplantation embryo. Hyperglycemia was found in obese women and is negatively correlated with oocyte maturity, fertilization rate and segmentation rate. This Hyperglycemia-induced apoptosis of progenitor cells in the embryo can affect differentiation of the remaining cells, manifesting later as malformations or miscarriages. Potential influences of maternal nutritional status in obesity are indicated by reports showing that periconceptual exposure to high energy substrates such as fatty acids and glucose results in perturbed oocyte and embryo mitochondrial metabolism. Altered oocyte and early embryo mitochondrial metabolism may be responsible for poor reproductive outcomes frequently reported in obese women. Conclusion: Encouraging weight loss in obese patients before responding to a request for medical assistance to procreation, should definitely integrate our practices.