title: Intra-follicular leptin concentration as a predictive factor for in vitro oocyte fertilization in assisted reproductive techniques.
abstract: BACKGROUND
  Granulosa-cells are able to produce and store leptin, suggesting that this hormone is locally involved in the regulation of follicular growth. In this study, the role of follicular fluid (FF) leptin concentration in predicting oocyte fertilization and embryo quality was evaluated in 35 normogonadotrophic women undergoing controlled ovarian stimulation (COS) for assisted reproductive techniques.
  
  
  METHODS
  Leptin concentration was measured in 47 consecutively collected FF in which a mature oocyte had been found during the ovum pick-up. Embryos deriving from fertilized oocytes were submitted to quality scoring systems.
  
  
  RESULTS
  Mean leptin concentration was significantly higher in FF whose oocytes showed 2 pronuclei (no. 25) when compared with those with no evidence of fertilization (no. 22) at the 16-18 h check (26.0+/-6.1 vs 15.3+/-10.6 ng/ml, respectively, p<0.01). Follicular mean diameters were similar in the two groups (21.4+/-3.4 and 21.0+/-5.1 mm, respectively). Logistic regression analysis identified FF leptin levels as the best predictive parameter for oocyte fertilization (p<0.001). When receiving operating characteristics curve was employed, a FF leptin concentration of 20.25 ng/ml was the most reliable cut-off in predicting fertilization of oocytes. FF with leptin concentrations higher than this value (no. 27) had an oocyte fertilization rate of 85.7%. In contrast, FF levels < or =20.25 ng/ml (no. 20) were associated with a rate of 16.7% (p<0.05). No correlation emerged between FF leptin and the score attributed to 15 valuable embryos at the zygote stage (r=-0.01) and at 48 h after insemination (r=0.1).
  
  
  CONCLUSIONS
  FF leptin levels are a better predictor of oocyte fertilization success rates than follicular diameter. These results underline the relevance of FF variables in developing methods for oocyte selection.
authors.affiliation: Department of Obstetrics Gynecology and Reproductive Medicine, University of Naples Federico II, 80128 Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: De Placido
authors.forename: C
authors.initials: C
authors.lastname: Alviggi
authors.forename: R
authors.initials: R
authors.lastname: Clarizia
authors.forename: A
authors.initials: A
authors.lastname: Mollo
authors.forename: E
authors.initials: E
authors.lastname: Alviggi
authors.forename: I
authors.initials: I
authors.lastname: Strina
authors.forename: E
authors.initials: E
authors.lastname: Fiore
authors.forename: M
authors.initials: M
authors.lastname: Wilding
authors.forename: T
authors.initials: T
authors.lastname: Pagano
authors.forename: G
authors.initials: G
authors.lastname: Matarese
mesh_terms: D000328:Adult; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D015571:Follicular Fluid / Q000737:chemistry / Q000378:metabolism* / Q000502:physiology; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000453:epidemiology / Q000628:therapy; D020738:Leptin / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D009865:Oocytes / Q000737:chemistry / Q000378:metabolism* / Q000502:physiology; D011237:Predictive Value of Tests; D027724:Reproductive Techniques, Assisted
chemical_list: D020738:Leptin