title: Serum and follicular fluid ghrelin levels negatively reflect human oocyte quality and in vitro embryo development.
abstract: OBJECTIVE
  To characterize serum and follicular fluid (FF) ghrelin in women undergoing assisted reproduction and to evaluate ghrelin's impact on ovarian steroidogenesis, oocyte quality, and embryo development.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  University-based center for assisted reproduction.
  
  
  METHODS
  Normal weight women (n = 31) without endocrinopathies undergoing IVF.
  
  
  METHODS
  Fasting serum and FF from individual preovulatory follicles (n = 81) were collected.
  
  
  METHODS
  Ghrelin, insulin, ovarian steroids, and IVF outcomes including oocyte maturity and embryo development were assessed.
  
  
  RESULTS
  The FF ghrelin correlated highly with serum levels and was 13% (3%-24%) lower. Levels were not associated with body mass or exogenous gonadotropins. Serum ghrelin correlated negatively with the cleavage rate and number of viable day 3 embryos. Embryos with successful cleavage and viable morphology came from follicles with lower ghrelin-odds ratios were 3.67 (1.02-13.14) and 3.46 (1.01-11.81), respectively. The FF ghrelin correlated negatively with FF insulin and progesterone, and positively with estradiol. The FF insulin was more than 50% higher (Δ = 1.88 [0.31-3.45] uIU/mL) in follicles with successfully cleaved embryos.
  
  
  CONCLUSIONS
  The FF ghrelin does not reflect ovarian production and likely represents transudation. Ghrelin in FF correlates with local steroidogenesis and FF insulin expression. Serum and FF ghrelin are reflective of embryo development, possibly through interactions with FF insulin.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Columbia University Medical Center, New York, New York 10032, USA. nuyilil@gmail.com
authors.forename: Liyun
authors.initials: L
authors.lastname: Li
authors.forename: Michel
authors.initials: M
authors.lastname: Ferin
authors.forename: Mark V
authors.initials: MV
authors.lastname: Sauer
authors.forename: Rogerio A
authors.initials: RA
authors.lastname: Lobo
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001755:Blastocyst / Q000378:metabolism; D002970:Cleavage Stage, Ovum / Q000378:metabolism; D046149:Embryo Culture Techniques; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000378:metabolism*; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D007246:Infertility / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D007328:Insulin / Q000378:metabolism; D016014:Linear Models; D009519:New York City; D016017:Odds Ratio; D054315:Oocyte Retrieval; D009865:Oocytes / Q000378:metabolism* / Q000473:pathology; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D015415:Biomarkers; C515349:GHRL protein, human; D054439:Ghrelin; D007328:Insulin