Skip to main content
Log in

The effect of serum and follicular fluid amyloid-associated protein levels on in vitro fertilization outcome in patients with polycystic ovary syndrome

  • Assisted Reproduction Technologies
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

In this study, we aimed to investigate serum and follicular fluid amyloid A protein levels in non-obese non-hyperandrogenic patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization (IVF) and IVF outcome.

Methods

A total of 81 patients undergoing IVF treatment, 41 patients diagnosed as PCOS according to the Rotterdam criteria (group I) and 40 patients with the etiology of male factor infertility (group II), were included in the study. On the day of oocyte pickup, serum and follicular fluid samples were collected from all patients.

Results

Serum E2 level on the day of hCG (2849.93 ± 541.54 vs. 2494.28 ± 712.98) and total number of retrieved oocytes (13.73 ± 3.57 vs. 10.53 ± 4.07) were significantly higher in group I when compared to group II (p < 0.05). However, number of mature oocytes, fertilization rate, and clinical pregnancy rate did not differ (p > 0.05). No significant difference was found between two groups regarding the serum and follicular fluid amyloid A protein levels on the day of oocyte retrieval (p > 0.05).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Manneras Holm L, Leonhardt H, Kullberg J, Jennische E, Oden A, Holm G, et al. Adipose tissue has aberrant morphology and function in PCOS: enlarged adipocytes and low serum adiponectin, but not circulating sex steroids, are strongly associated with insulin resistance. J Clin Endocrinol Metab. 2011;96:E304–11.

    Article  CAS  PubMed  Google Scholar 

  2. Tan BK, Adya R, Shan X, Aghilla M, Lehnert H, Keay SD, et al. The anti-atherogenic aspect of metformin treatment in insulin resistant women with the polycystic ovary syndrome: role of the newly established pro-inflammatory adipokine Acute-phase Serum Amyloid A; evidence of an adipose tissue-monocyte axis. Atherosclerosis. 2011;216:402–8.

    Article  CAS  PubMed  Google Scholar 

  3. Borruel S, Fernandez-Duran E, Alpanes M, Marti D, Alvarez-Blasco F, Luque Ramirez M, et al. Global adiposity and thickness of intraperitoneal and mesenteric adipose tissue depots are increased in women with polycystic ovary syndrome (PCOS). J Clin Endocrinol Metab. 2013;98:1254–63.

    Article  CAS  PubMed  Google Scholar 

  4. Yang RZ, Lee MJ, Hu H, Pollin TI, Ryan AS, Nicklas BJ, et al. Acute phase serum amyloid A: an inflammatory adipokine and potential link between obesity and its metabolic complications. PLoS Med. 2006;3:e287.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Escobar-Morreale HF, Luque-Ramírez M, González F. Circulating inflammatory markers in polycystic ovary syndrome: a systematic review and metaanalysis. Fertil Steril. 2011;95(3):1048–58.e1-2.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Duleba AJ, Dokras A. Is PCOS an inflammatory process? Fertil Steril. 2012;97:7–12.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Sarapik A, Velthut A, Haller-Kikkatalo K, Faure GC, Bene MC, de Carvalho Bittencourt M, et al. Follicular proinflammatory cytokines and chemokines as markers of IVF success. Clin Dev Immunol. 2012;2012:606459. doi:10.1155/2012/606459.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Malizia BA, Wook YS, Penzias AS, Usheva A. The human ovarian follicular fluid level of interleukin-8 is associated with follicular size and patient age. Fertil Steril. 2010;93(2):537–43. doi:10.1016/j.fertnstert.2008.11.033.

    Article  CAS  PubMed  Google Scholar 

  9. Vujisic S, Lepej SZ, Emedi I, Bauman R, Remenar A, Tiljak MK. Ovarian follicular concentration of IL-12, IL-15, IL-18 and p40 subunit of IL-12 and IL-23. Hum Reprod. 2006;21(10):2650–5.

    Article  CAS  PubMed  Google Scholar 

  10. Winger EE, Reed JL, Ashoush S, El-Toukhy T, Taranissi M. Die-off ratio correlates with increased TNF-α:IL-10 ratio and decreased IVF success rates correctable with humira. Am J Reprod Immunol. 2012;68(5):428–37. doi:10.1111/j.1600-0897.2012.01179.x.

    Article  CAS  PubMed  Google Scholar 

  11. Levin I, Gamzu R, Mashiach R, Lessing JB, Amit A, Almog B. Higher Creactive protein levels during IVF stimulation are associated with ART failure. J Reprod Immunol. 2007;75(2):141–4.

    Article  CAS  PubMed  Google Scholar 

  12. Gidwani S, Phelan N, Mcgill J, Mcgowan A, O'Connor A, Young IS, et al. Polycystic ovary syndrome influences the level of serum amyloid A and activity of phospholipid transfer protein in HDL2 and HDL3. Hum Reprod. 2014;29:1518–25.

    Article  CAS  PubMed  Google Scholar 

  13. Blair SA, Kyaw-Tun T, Young IS, Phelan NA, Gibney J, Mceneny J. Oxidative stress and inflammation in lean and obese subjects with PCOS. J Reprod Med. 2013;58:107–14.

    CAS  PubMed  Google Scholar 

  14. Berger DS, Zapantis A, Merhi Z, Younger J, Polotsky AJ, Jindal SK. Embryo quality but not pronuclear score is associated with clinical pregnancy following IVF. J Assist Reprod Genet. 2014;31(3):279–83. doi:10.1007/s10815-013-0162-3.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. van der Linden M, Buckingham K, Farquhar C, Kremer JA, Metwally M. Luteal phase support for assisted reproduction cycles. Cochrane Database Syst Rev. 2015;7:CD009154. doi:10.1002/14651858.CD009154.pub3.

    PubMed  Google Scholar 

  16. Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev. 2012;33(6):981–1030. doi:10.1210/er.2011-1034.

    Article  CAS  PubMed  Google Scholar 

  17. Hojlund K. Metabolism and insulin signaling in common metabolic disorders and inherited insulin resistance. Dan Med J. 2014;61(7):B4890.

    PubMed  Google Scholar 

  18. Alebic MS, Bulum T, Stojanović N, Duvnjak L. Definition of insulin resistance using the homeostasis model assessment (HOMA-IR) in IVF patients diagnosed with polycystic ovary syndrome (PCOS) according to the Rotterdam criteria. Endocrine. 2014;47(2):625–30. doi:10.1007/s12020-014-0182-5.

    Article  CAS  PubMed  Google Scholar 

  19. Apridonidze T, Essah PA, Iuorno MJ, Nestler JE. Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005;90:1929–35.

    Article  CAS  PubMed  Google Scholar 

  20. Carmina E, Bucchieri S, Esposito A, Del Puente A, Mansueto P, Orio F, et al. Abdominal fat quantity and distribution in women with polycystic ovary syndrome and extent of its relation to insulin resistance. J Clin Endocrinol Metab. 2007;92:2500–5.

    Article  CAS  PubMed  Google Scholar 

  21. Hotamisligil GS, Shargill NS, Spiegelman BM. Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance. Science. 1993;259:87–91.

    Article  CAS  PubMed  Google Scholar 

  22. Yap SH, Moshage HJ, Hazenberg BPC, Roelofs HM, Bijzet J, Limburg PC, et al. Tumor necrosis factor (Tnf) inhibits interleukin (Il)-1 and/or Il-6 stimulated synthesis of C-reactive protein (Crp) and serum amyloid a (Saa) in primary cultures of human hepatocytes. Biochim Biophys Acta. 1991;1091:405–8.

    Article  CAS  PubMed  Google Scholar 

  23. Urieli-Shoval S, Finci Yeheskel Z, Eldar I, Linke RP, Levin M, Prus D, et al. Serum amyloid a: expression throughout human ovarian folliculogenesis and levels in follicular fluid of women undergoing controlled ovarian stimulation. J Clin Endocrinol Metab. 2013;98:4970–8.

    Article  CAS  PubMed  Google Scholar 

  24. O'Brien KD, Chait A. Serum amyloid A: the "other" inflammatory protein. Curr Atheroscler Rep. 2006;8:62–8.

    Article  PubMed  Google Scholar 

  25. Sjoholm K, Palming J, Olofsson LE, Gummesson A, Svensson PA, Lystig TC, et al. A microarray search for genes predominantly expressed in human omental adipocytes: adipose tissue as a major production site of serum amyloid A. J Clin Endocrinol Metab. 2005;90:2233–9.

    Article  PubMed  Google Scholar 

  26. Jernas M, Palming J, Sjoholm K, Jennische E, Svensson PA, Gabrielsson BG, et al. Separation of human adipocytes by size: hypertrphic fat cells display distinct gene expression. FASEB J. 2006;20:1540–42.

    Article  CAS  PubMed  Google Scholar 

  27. Orvieto R. Controlled ovarian hyperstimulation-an inflammatory state. J Soc Gynecol Investig. 2004;11:424–26.

    Article  CAS  PubMed  Google Scholar 

  28. Urieli-Shoval S, Linke RP, Matzner Y. Expression and function of serum amyloid A, a major acute phase protein, in normal and disease states. Curr Opin Hematol. 2000;7:64–9.

    Article  CAS  PubMed  Google Scholar 

  29. Kahyaoglu I, Yilmaz N, Timur H, Inal HA, Erkaya S. Granulocyte colonystimulating factor: A relation between serum and follicular fluid levels and in-vitro fertilization outcome in patients with polycystic ovary syndrome. Cytokine. 2015;74(1):113–6.

    Article  CAS  PubMed  Google Scholar 

  30. Orvieto R, Chen R, Ashkenazi J, Ben-Haroush A, Bar J, Fisch B. C-reactive protein levels in patients undergoing controlled ovarian hyperstimulation for IVF cycle. Hum Reprod. 2004;19(2):357–9.

    Article  CAS  PubMed  Google Scholar 

  31. Wunder DM, Kretschmer R, Bersinger NA. Concentrations of leptin and Creactive protein in serum and follicular fluid during assisted reproductive cycles. Hum Reprod. 2005;20(5):1266–71.

    Article  CAS  PubMed  Google Scholar 

  32. Robinson S, Pemberton P, Laing I, Nardo LG. Low grade inflammation, as evidenced by basal high sensitivity CRP, is not correlated to outcome measures in IVF. J Assist Reprod Genet. 2008;25(8):383–8.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hakan Timur.

Additional information

Capsule In a selected population of non-obese non-hyperandrogenic PCOS patients, no significant difference is detected between the study and the control group regarding the amyloid A levels despite the inflammatory nature of PCOS and IVF outcome.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Timur, H., Yimaz, N., Kahyaoglu, I. et al. The effect of serum and follicular fluid amyloid-associated protein levels on in vitro fertilization outcome in patients with polycystic ovary syndrome. J Assist Reprod Genet 32, 1637–1642 (2015). https://doi.org/10.1007/s10815-015-0582-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-015-0582-3

Keywords

Navigation