Another Marker to Predict the Outcome of IVF for Women with Endometriosis

The concentration of AOPPs, a marker of oxidative stress, could help predict egg quality and IVF outcome

Key Points

Highlights:

• Advanced oxidative protein products (AOPP), a measure of oxidative stress, could be used as a marker to predict egg quality and IVF outcome in infertile women with endometriosis.

Importance:

• Anti-oxidative therapies could be used to increase egg quality and the IVF success rates. 

What's done here:

• Researchers from China analyzed levels of AOPP, estrogen, and progesterone in the follicular fluid of 89 women with and without endometriosis undergoing IVF treatment, to investigate whether endometriosis-associated infertility is linked to reduced egg quality due to oxidative stress. 

Key results

• The concentration of AOPP in the follicular fluid of women with endometriosis was significantly higher than women without endometriosis.
• The levels of progesterone and rate of development of the fertilized eggs were significantly lower in women with endometriosis compared to women without endometriosis. 
• There was a significant negative correlation between the concentration of AOPPs and the levels of progesterone in the follicular fluid of both women with endometriosis and those without. 
• There was a significant negative correlation between the concentration of AOPPs in the follicular fluid of women with endometriosis and the development rate of the fertilized eggs.

Limitations of the study:

• The overall patient number was small 

• No significant correlations were observed between the levels of AOPPs in the follicular fluid and other hormones, although this does not necessarily mean that there is no correlation. Larger studies may find such correlations.

Lay Summary

AOPPs or advanced oxidative protein products may be new markers to predict egg quality and the outcomes of IVF in infertile women with endometriosis according to a study published in the journal Experimental and Therapeutic Medicine. This finding suggests that anti-oxidative treatments that can reduce the levels of AOPPs may potentially be used as a treatment to increase egg quality and IVF success rates.

Oxidative stress is an imbalance between free radicals (also called reactive oxygen species or ROS) that are produced as a result of normal cellular metabolism and the body’s ability to neutralize them. ROS plays an important role in the female reproductive system but too much of it is harmful and can lead to infertility. Infertility is very common among women with endometriosis and the exact cause is not fully understood. However, it is known that there is a correlation between endometriosis and oxidative stress.

Researchers from China wanted to investigate whether endometriosis-associated infertility is linked to reduced egg quality due to oxidative stress. To do so, they used AOPP as a marker of oxidative stress that could easily be measured. AOPPs are markers of protein damage caused by oxidation and because they stay in the blood for several hours or even days they are great markers of oxidative stress.

In order to test their hypothesis the team led by Dr. Song Quan at the Center for Reproductive Medicine, Nanfang Hospital in China measured the levels of AOPPs, estradiol, and progesterone, the major female sex hormones, in the follicular fluid, or fluid that surrounds the egg cell in 89 infertile women with or without endometriosis undergoing IVF. They found that the concentration of AOPPs in the follicular fluid of women with endometriosis was significantly higher compared to women without endometriosis, pointing to a higher rate of oxidative stress. In addition, the levels of progesterone and rate of development of the fertilized eggs were significantly lower in women with endometriosis.

The researchers calculated that the higher the concentration of AOPP was the lower the levels of progesterone were both in women with endometriosis and in those without. Similarly, the higher the concentration of AOPPs were the lower the development rate of the fertilized eggs were. But this was not the case for infertile women without endometriosis.

The researchers concluded that the concentration of AOPP could be a good marker to predict the chance of IVF success.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/29387200