Obesity is associated with a higher level of pro-inflammatory cytokines in follicular fluid of women undergoing medically assisted procreation (PMA) programs.

摘要

INTRODUCTION: Cytokines are glycoproteins that modulate reproductive function through a series of various mechanisms (by both conditioning gonadal steroidogenesis and contributing to the preservation of an inflammatory microenvironment). AIM OF THE STUDY: To evaluate the impact of certain clinical variables (i.e., age, obesity, insulin resistance index, serum antithyroid antibodies serum levels) on the serum concentrations of cytokines TNF-alpha, IL-6, and IL-10 in the follicular fluid of women undergoing a medically assisted procreation (PMA) cycle. MATERIALS AND METHODS: A total of 40 female patients undergoing an intracytoplasmic sperm injection (ICSI) in oocytes, following ovarian stimulation by purified FSH and hCG carried out after suppression of ovarian function. The follicular fluid, obtained by surgical ultrasonography-guided withdrawal, was stored at -30 degrees C. Subsequently the cytokines were assayed by ELISA technique. RESULTS: Women suffering from class II obesity showed follicular levels of TNF-alpha significantly higher (p < 0.05) than women with a normal body mass index (BMI). Significantly higher concentrations of TNF-alpha and IL-6 were found in women with HOMA index > 2.5. Women clinically presenting with concomitant obesity and high serum levels of antithyroid antibodies were found to have higher follicular levels of TNF-alpha and IL-6 (p < 0.05) in comparison with women suffering from obesity only or low antithyroid antibodies levels only, or from both these conditions. CONCLUSION: Obesity is a common clinical condition associated with a higher concentration of inflammatory substances in the follicular fluid of infertile women. It is not understood, as yet, the possible pejorative role exerted by the presence of other clinical conditions, such as insulin resistance and high levels of antithyroid antibodies, that are conditions frequently encountered in the clinical practice.