title: Assessment of follicular fluid leptin levels and insulin resistance as outcome predictors in women undergoing in vitro fertilization-intracytoplasmic sperm injection.
abstract: OBJECTIVE
  To analyze follicular fluid leptin (FFL) levels, abdominal obesity, and insulin resistance as predictors of in vitro fertilization (IVF)-intracytoplasmic sperm injection (ICSI) outcome.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  A sample of 130 infertile women aged 26-40 years without polycystic ovary syndrome.
  
  
  METHODS
  Measurement of FFL levels in controlled ovarian hyperstimulation cycles with an antagonist and agonist protocol for IVF-ICSI.
  
  
  METHODS
  Live birth rate.
  
  
  RESULTS
  Mean FFL values were significantly higher in pregnancies not ending in a live birth, even after adjustment for waist circumference and insulin resistance. A multivariable model obtained with the use of logistic binary regression analysis showed that waist circumference and insulin resistance had no influence over IVF-ICSI outcomes, but a higher number of follicles, lower serum progesterone levels on the day before α-hCG administration, and lower FFL concentrations were significantly associated with a higher probability of having a live birth. The multivariate model reached a sensitivity of 87% and a specificity of 71% for predicting the possibility of pregnancy ending in a live birth.
  
  
  CONCLUSIONS
  High FFL levels were associated with abdominal obesity, insulin resistance, and a lower live birth rate after IVF-ICSI. Further investigations are warranted to define the precise roles of leptin, obesity, and insulin resistance on IVF-ICSI outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, University Central Hospital of Asturias, University of Oviedo, Oviedo, Spain; Asturias In Vitro Fertilization Center (CEFIVA), Oviedo, Spain. Electronic address: llaneza@uniovi.es.
authors.forename: David
authors.initials: D
authors.lastname: Llaneza-Suarez
authors.affiliation: Department of Obstetrics and Gynecology, University Central Hospital of Asturias, University of Oviedo, Oviedo, Spain.
authors.forename: Placido
authors.initials: P
authors.lastname: Llaneza
authors.affiliation: Department of Physiology, University of Oviedo, Oviedo, Spain.
authors.forename: Celestino
authors.initials: C
authors.lastname: González
authors.affiliation: Department of Physiology, University of Oviedo, Oviedo, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: De-La-Fuente
authors.affiliation: Asturias In Vitro Fertilization Center (CEFIVA), Oviedo, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: García-Ochoa
authors.affiliation: Department of Physiology, University of Oviedo, Oviedo, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Garrido
authors.affiliation: Department of Obstetrics and Gynecology, University Central Hospital of Asturias, University of Oviedo, Oviedo, Spain.
authors.forename: Vanesa
authors.initials: V
authors.lastname: Castañón
authors.affiliation: Department of Obstetrics and Gynecology, "Lozano Blesa" University Hospital, University of Zaragoza, Zaragoza, Spain.
authors.forename: Faustino R
authors.initials: FR
authors.lastname: Pérez-López
mesh_terms: D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000737:chemistry*; D006801:Humans; D007333:Insulin Resistance; D020738:Leptin / Q000378:metabolism*; D056128:Obesity, Abdominal; D006080:Ovarian Follicle / Q000502:physiology; D011247:Pregnancy; D018873:Pregnancy Rate; D012680:Sensitivity and Specificity; D020554:Sperm Injections, Intracytoplasmic; D055105:Waist Circumference
chemical_list: D020738:Leptin
keywords: Assisted reproduction; ICSI; IVF; fertility; follicular fluid; insulin resistance; leptin