title: Baseline non-fasting serum leptin concentration to body mass index ratio is predictive of IVF outcomes.
abstract: BACKGROUND
  The present study was designed to determine whether circulating leptin concentrations and/or body mass index (BMI) in women undergoing IVF are predictive of outcomes.
  
  
  METHODS
  IVF cycle outcomes, e.g. fertilization, embryo development, implantation, pregnancy, were analysed relative to baseline (i.e. day gonadotrophin stimulation was initiated) non-fasting serum leptin concentrations and BMI.
  
  
  RESULTS
  Serum leptin concentrations correlated with BMI (r = 0.739, P < 0.0001) as expected. Multiple logistic regression analyses showed correlation between serum leptin and pregnancy success (likelihood ratio = 5.198, P < 0.05), but there was no association between pregnancy and BMI. However, the serum leptin to BMI ratio was more strongly correlated (likelihood ratio = 7.258, P < 0.01) with pregnancy success than was leptin alone. Moreover, women with a low leptin:BMI ratio (< or =0.3) had significantly more superior quality embryos on day 3 post-retrieval (2.5 versus 1.4, P < 0.05, Kruskal-Wallis) and a greater implantation rate (26.7 versus 13.2%, P < 0.025, chi(2)) than women with a high leptin:BMI ratio (> or =0.7).
  
  
  CONCLUSIONS
  The leptin:BMI ratio appears to be highly predictive of IVF success. Elevated leptin concentrations, particularly relative to BMI, may negatively impact fertility by assisted reproduction, possibly through direct ovarian actions resulting in impaired oocyte quality and/or early embryo development.
authors.affiliation: Department of Obstetrics and Gynecology, University of South Dakota School of Medicine, South Dakota, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Brannian
authors.forename: S M
authors.initials: SM
authors.lastname: Schmidt
authors.forename: D O
authors.initials: DO
authors.lastname: Kreger
authors.forename: K A
authors.initials: KA
authors.lastname: Hansen
mesh_terms: D000328:Adult; D015992:Body Mass Index; D010064:Embryo Implantation; D004622:Embryo, Mammalian / Q000502:physiology; D005260:Female; D005307:Fertilization in Vitro; D005544:Forecasting; D006801:Humans; D020738:Leptin / Q000097:blood*; D016013:Likelihood Functions; D009994:Osmolar Concentration; D011247:Pregnancy; D016896:Treatment Outcome
chemical_list: D020738:Leptin