Preconception serum lipids and lipophilic micronutrient levels are associated with live birth rates after IVF

Erica L Jamro; Michael S Bloom; Richard W Browne; Keewan Kim; Eleni A Greenwood; Victor Y Fujimoto

doi:10.1016/j.rbmo.2019.06.004

Preconception serum lipids and lipophilic micronutrient levels are associated with live birth rates after IVF

Reprod Biomed Online. 2019 Oct;39(4):665-673. doi: 10.1016/j.rbmo.2019.06.004. Epub 2019 Jun 14.

Authors

Erica L Jamro¹, Michael S Bloom², Richard W Browne³, Keewan Kim⁴, Eleni A Greenwood⁵, Victor Y Fujimoto⁵

Affiliations

¹ Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer NY 12144, USA.
² Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer NY 12144, USA; Department of Environmental Health Sciences, University at Albany, State University of New York, One University Place, School of Public Health, GEC #157, Rensselaer NY 12144, USA. Electronic address: mbloom@albany.edu.
³ Department of Biotechnical and Clinical Laboratory Sciences, University at Buffalo, State University of New York, Buffalo NY 14214, USA.
⁴ Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda MD 20892, USA.
⁵ Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, San Francisco CA 94158, USA.

Abstract

Research question: Is a mixture of preconception serum lipids and lipophilic micronutrients associated with clinical pregnancy and live births?

Design: In this prospective cohort study, blood serum was collected on the day of oocyte retrieval for 180 women undergoing IVF at an academic reproductive health centre. Concentrations of lipids (phospholipids, total cholesterol, high- and low-density lipoproteins, and triglycerides) and lipophilic micronutrients (α-, δ-, and γ-tocopherols, retinol, β- and α-carotenes, β-cryptoxanthin, lutein and lycopene) were determined using diagnostic reagent kits and high-performance liquid chromatography. Poisson regression was used with robust variance estimation to evaluate changes in Z-scores for the mixture of serum lipid and lipophilic micronutrient concentrations as predictors of embryo implantation, clinical pregnancy and live birth, adjusted for age, body mass index (BMI), race, smoking status, infertility diagnosis, ovarian stimulation protocol and other measured lipid and lipophilic micronutrient concentrations.

Results: Each SD higher serum triglyceride concentration was associated with a lower chance of live birth (RR 0.54; 95% CI 0.33 to 0.90) whereas a 1 SD higher serum α-tocopherol concentration, as part of a mixture of serum lipids and lipophilic micronutrients, was associated with a higher likelihood for a live birth (RR 1.61; 95% CI 1.11 to 2.36). Serum β-carotene concentrations were associated with live birth in a non-linear fashion; low β-carotene was associated with a lower chance of live birth and high β-carotene with a higher chance of live birth.

Conclusion: Although components of a mixture of lipids and lipophilic micronutrients were associated with live birth outcomes after IVF, a larger investigation is necessary to fully evaluate the potential clinical implications.

Keywords: Alpha-tocopherol; In vitro fertilization (IVF); Lipids; Live birth; Micronutrients; Triglycerides.

MeSH terms

Adult
Cohort Studies
Female
Fertilization in Vitro* / methods
Fertilization in Vitro* / statistics & numerical data
Humans
Infant, Newborn
Infertility / blood*
Infertility / epidemiology
Infertility / therapy*
Lipids / blood*
Live Birth / epidemiology*
Male
Micronutrients / blood*
Middle Aged
Ovulation Induction
Pregnancy
Pregnancy Outcome / epidemiology
Pregnancy Rate*
Prospective Studies

Substances

Lipids
Micronutrients

Grants and funding

R21 AG031957/AG/NIA NIH HHS/United States