Inflammation mediates the effect of adiposity and lipid metabolism indicators on the embryogenesis of PCOS women undergoing in vitro fertilization/intracytoplasmic sperm injection

Front Endocrinol (Lausanne). 2023 Jul 25:14:1198602. doi: 10.3389/fendo.2023.1198602. eCollection 2023.

Abstract

Background: Polycystic ovary syndrome (PCOS) is a complex reproductive endocrine and metabolic disease affecting women of reproductive age. The low-grade chronic inflammation in PCOS is considered to be associated with obesity and dyslipidemia. We aim to investigate the potential mediating role of white blood cell (WBC) count, a representative inflammatory marker, in the effect of adiposity and lipid metabolism indicators on IVF/ICSI outcomes in PCOS women.

Methods: We conducted a retrospective cohort study of 1,534 PCOS women who underwent their first IVF/ICSI cycles with autologous oocytes at a reproductive center from January 2018 to December 2020. The associations between PCOS women's adiposity and lipid metabolism indicators and WBC count and IVF/ICSI outcomes were examined using multivariable generalized linear models. Mediation analyses were conducted to evaluate the possible mediating role of WBC count.

Results: We found significant dose-dependent correlations between adiposity and lipid metabolism indicators and IVF/ICSI outcomes (i.e., hormone levels on the ovulatory triggering day, oocyte development outcomes, fertilization, early embryo development outcomes, and pregnancy outcomes) (all p < 0.05), as well as between adiposity and lipid metabolism indicators and WBC count (all p < 0.001). Increasing WBC count was associated with adverse oocyte and embryonic development outcomes (all p < 0.05). Mediation analyses suggested that increasing serum TG and LDL-C levels and decreasing serum HDL-C level were significantly associated with reduced high-quality Day 3 embryo count in PCOS women, with 21.51%, 9.75%, and 14.10% mediated by WBC count, respectively (all p < 0.05).

Conclusions: We observed significant associations between lipid metabolism indicators and high-quality Day 3 embryo count in PCOS women, partially mediated by inflammation-related mechanisms, suggesting the potential intervention target for improving embryo quality in PCOS women.

Keywords: IVF/ICSI outcomes; PCOS; adiposity; inflammation; lipid metabolism; mediating effect.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiposity
  • Embryonic Development
  • Female
  • Fertilization in Vitro
  • Humans
  • Lipid Metabolism
  • Male
  • Obesity / complications
  • Polycystic Ovary Syndrome* / complications
  • Pregnancy
  • Retrospective Studies
  • Semen
  • Sperm Injections, Intracytoplasmic*

Grants and funding

This work was partly supported by the National Natural Science Foundation of China (Nos. 81701407, 82171626, 82171632, 82201839, and 82288102), the National Key Research and Development Program of China (Nos. 2021YFC2700605 and 2022YFC2702901), and the Beijing Science and Technology Planning Project (No. Z191100006619085).