Frontiers of Medicine

, Volume 11, Issue 2, pp 247–252 | Cite as

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
Research Article


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 IVembryos. 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.


in vitro fertilization PCOS free radical embryo quality 


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This study was supported by the Chinese Society of Reproductive Medicine (No. 16020520668).


  1. 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: 3078–3082PubMedGoogle Scholar
  2. 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): 2245–2252CrossRefPubMedGoogle Scholar
  3. 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: 263–270CrossRefGoogle Scholar
  4. 4.
    Mikola M, Hiilesmaa V, Halttunen M, Suhonen L, Tiitinen A. Obstetric outcome in women with polycystic ovarian syndrome. Hum Reprod 2001; 16(2): 226–229CrossRefPubMedGoogle Scholar
  5. 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): 673–683CrossRefPubMedGoogle Scholar
  6. 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): 407–413CrossRefPubMedGoogle Scholar
  7. 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): 105–110CrossRefGoogle Scholar
  8. 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): e106854CrossRefPubMedPubMedCentralGoogle Scholar
  9. 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 a in IVF/ICSI cycles? A systematic review and meta-analysis. Fertil Steril 2012; 97(4): 876–885CrossRefPubMedGoogle Scholar
  10. 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): 65–71CrossRefPubMedGoogle Scholar
  11. 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: 747–754PubMedPubMedCentralGoogle Scholar
  12. 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): 475–478CrossRefPubMedGoogle Scholar
  13. 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): 654–657CrossRefPubMedGoogle Scholar
  14. 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): 446–456CrossRefPubMedGoogle Scholar
  15. 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): 765–772CrossRefPubMedPubMedCentralGoogle Scholar
  16. 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): 444–448CrossRefPubMedGoogle Scholar
  17. 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): 639–643CrossRefPubMedGoogle Scholar
  18. 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): 46–50CrossRefPubMedGoogle Scholar
  19. 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): 2465–2466CrossRefPubMedGoogle Scholar
  20. 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): 2080–2085CrossRefGoogle Scholar
  21. 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): 1171–1176CrossRefPubMedGoogle Scholar
  22. 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.e1Google Scholar
  23. 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): e0145895CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Huang B, Li Z, Ai J, Zhu L, Li Y, Jin L, Zhang H. Antioxidant capacity of follicular fluid from patients undergoing in vitro fertilization. Int J Clin Exp Pathol 2014; 7(5): 2273–2282PubMedPubMedCentralGoogle Scholar
  25. 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): 1345–1349CrossRefPubMedGoogle Scholar
  26. 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): 88–93CrossRefPubMedGoogle Scholar
  27. 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: 16346–16352Google Scholar
  28. 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): 185–190CrossRefPubMedGoogle Scholar
  29. 29.
    Jana SK, 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): 447–451CrossRefPubMedGoogle Scholar
  30. 30.
    Veeck LL. An atlas of human gametes and conceptuses: an illustrated reference for assisted reproductive technology. New York: Parthenon Publishing, 1999CrossRefGoogle Scholar
  31. 31.
    Kusçu 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): 612–617CrossRefPubMedGoogle Scholar
  32. 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: 148–152CrossRefPubMedGoogle Scholar
  33. 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): 1128–1135CrossRefPubMedGoogle Scholar
  34. 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): 55–59CrossRefPubMedGoogle Scholar
  35. 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): 2493–2495CrossRefPubMedGoogle Scholar
  36. 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): 998–1002CrossRefPubMedGoogle Scholar
  37. 37.
    Fortier ME, Audet I, Giguere A, Laforest JP, Bilodeau JF, Quesnel H, Matte JJ. Effect of dietary organic and inorganic selenium on antioxidant status, embryo development, and reproductive performance in hyperovulatory first-parity gilts. J Anim Sci 2012; 90(1): 231–240CrossRefPubMedGoogle Scholar

Copyright information

© Higher Education Press and Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Reproductive Medicine Center, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina

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