Effect of oxidative stress in follicular fluid on the outcome of assisted reproductive procedures

Objective(s): To measure levels of lipid peroxidation (LPO) and total antioxidant capacity (TAC) in the follicular fluid from patients undergoing IVF and to examine the association among LPO and TAC and oocyte maturity, embryo quality, fertilization, cleavage, and pregnancy rates. Design: Prospective study. Setting: Tertiary care medical center. Patient(s): Forty-one patients undergoing IVF. Intervention(s): Clear follicular fluid specimens were collected at oocyte retrieval. Main Outcome Measure(s): Follicular fluid LPO and TAC levels measured by the thiobarbituric acid and the chemiluminescence method, respectively. Result(s): The mean LPO level was 0.95 mumol malonaldehyde/L, and the mean TAC level was 819.16 Trolox equivalents. No correlation was seen among LPO or TAC levels and oocyte maturity, fertilization, cleavage, and embryo quality. The pregnancy rate was 31.7%. Pregnant patients were significantly younger than the patients who did not become Pregnant (30.53 +/- 3.5 years vs. 34.32 +/- 3.98 years). After adjusting for age, a positive correlation was seen between pregnancy rate and LPO and between pregnancy rate and TAC. Conclusion(s): Both LPO and TAC levels were positively correlated with the pregnancy rate. Lipid peroxidation may be a good marker of metabolic activity within the follicle, and some amounts may be necessary to establish a pregnancy. (C) 2004 by American Society for Reproductive Medicine.