The influence of non-esterified fatty acids on the ovarian production of androgens in a context of in vitro fertilisation Preliminary results

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 498-523-Female Reproductive Endocrinology & Case Reports
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-511
Alexandre Gervais*, Marie Claude Battista, Belina Carranza-Mamane and Jean-Patrice Baillargeon
Centre Hosp Univ de Sherbrooke, Sherbrooke, QC, Canada
Polycystic ovary syndrome (PCOS) is the main cause of anovulatory infertility and is mainly characterized by excessive production of androgens. Several studies suggest that lipotoxicity (lipid-induced cellular toxicity) can cause diabetes and we have shown that it can trigger androgen production in vitro. Our objectives were thus to : 1) compare NEFA levels in follicular fluid (FF) obtained during in vitro fertilisation (IVF) between women with and without PCOS; and 2) correlate these levels to FF levels of NEFA toxic metabolites (DAG & ceramides), androgens and parameters of insulin resistance, inflammation and oxidative stress.

Methods: Women undergoing IVF were recruited at a single assisted reproduction clinic. Three of them were diagnosed with PCOS based on the AE-PCOS criteria and twenty-nine were recruited as controls with other causes of infertility. FF was collected during oocyte aspiration and frozen for later measurement of the above-mentioned parameters. At this point, only NEFA (colorimetric assay) and testosterone (LC-MS/MS) have been assayed. Correlation between these measurements was tested using Spearman’s correlation analysis.

Results: The average ages for PCOS and control women were respectively 32.3 and 33.5 y/o, BMI were 32.9 and 25.0 Kg/m2, testosterone levels were 14.6 and 1.3 nM, and NEFA levels were 0.27 and 0.27 mM. Although NEFA levels were similar between groups, our preliminary data suggest that FF testosterone levels are >10 fold higher in PCOS vs control women. In the control group, a statistically significant positive correlation was observed between NEFA and testosterone levels (r=0.41, P=0.03), which remained significant after correction for BMI (P=0.03).

Conclusion: Our preliminary results suggest that NEFAs may increase ovarian production of androgens in infertile women without PCOS. In the small sample of PCOS women recruited so far, it seems that FF testosterone levels were increased, but NEFA levels were similar; which may suggest that NEFAs have higher lipotoxic effects in PCOS vs control women.

Perspective: More PCOS women will be recruited in order to increase the power of the study and to compare FF levels of the above-mentioned parameters between groups. The impact of PCOS status on the correlations of FF levels of NEFA or lipotoxic markers with the other parameters and fertility outcome, will allow to conclude on the mechanisms by which NEFAs affect ovarian androgen production in PCOS as compared to control women.

Nothing to Disclose: AG, MCB, BC, JPB

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