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. 2023 Jul 25:14:1198602.
doi: 10.3389/fendo.2023.1198602. eCollection 2023.

Inflammation mediates the effect of adiposity and lipid metabolism indicators on the embryogenesis of PCOS women undergoing in vitro fertilization/intracytoplasmic sperm injection

Huahua Jiang  1   2   3   4 , Lixue Chen  1   2   3   4 , Tian Tian  1   2   3   4 , Huifeng Shi  2   5   6 , Ning Huang  1   2   3   4 , Hongbin Chi  1   2   3   4 , Rui Yang  1   2   3   4 , Xiaoyu Long  1   2   3   4 , Jie Qiao  1   2   3   4   7   8
Affiliations

Inflammation mediates the effect of adiposity and lipid metabolism indicators on the embryogenesis of PCOS women undergoing in vitro fertilization/intracytoplasmic sperm injection

Huahua Jiang et al. Front Endocrinol (Lausanne). .

Abstract

Background: Polycystic ovary syndrome (PCOS) is a complex reproductive endocrine and metabolic disease affecting women of reproductive age. The low-grade chronic inflammation in PCOS is considered to be associated with obesity and dyslipidemia. We aim to investigate the potential mediating role of white blood cell (WBC) count, a representative inflammatory marker, in the effect of adiposity and lipid metabolism indicators on IVF/ICSI outcomes in PCOS women.

Methods: We conducted a retrospective cohort study of 1,534 PCOS women who underwent their first IVF/ICSI cycles with autologous oocytes at a reproductive center from January 2018 to December 2020. The associations between PCOS women's adiposity and lipid metabolism indicators and WBC count and IVF/ICSI outcomes were examined using multivariable generalized linear models. Mediation analyses were conducted to evaluate the possible mediating role of WBC count.

Results: We found significant dose-dependent correlations between adiposity and lipid metabolism indicators and IVF/ICSI outcomes (i.e., hormone levels on the ovulatory triggering day, oocyte development outcomes, fertilization, early embryo development outcomes, and pregnancy outcomes) (all p < 0.05), as well as between adiposity and lipid metabolism indicators and WBC count (all p < 0.001). Increasing WBC count was associated with adverse oocyte and embryonic development outcomes (all p < 0.05). Mediation analyses suggested that increasing serum TG and LDL-C levels and decreasing serum HDL-C level were significantly associated with reduced high-quality Day 3 embryo count in PCOS women, with 21.51%, 9.75%, and 14.10% mediated by WBC count, respectively (all p < 0.05).

Conclusions: We observed significant associations between lipid metabolism indicators and high-quality Day 3 embryo count in PCOS women, partially mediated by inflammation-related mechanisms, suggesting the potential intervention target for improving embryo quality in PCOS women.

Keywords: IVF/ICSI outcomes; PCOS; adiposity; inflammation; lipid metabolism; mediating effect.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Mediating effects of WBC count on the associations between adiposity and lipid metabolism indicators and high-quality Day 3 embryo count. Adjusted for age (continuous), AFC (continuous), and infertility type. Adiposity and lipid metabolism indicators and WBC count were transformed by natural logarithm. ACME: average causal mediating effect. This represents the indirect effect, also known as the mediating effect of WBC count on the associations between adiposity and lipid metabolism indicators and high-quality embryo count. ADE: average direct effect. This represents the effects of adiposity and lipid metabolism indicators on high-quality Day 3 embryo count when WBC count is controlled. *p < 0.05. **p < 0.01.
See this image and copyright information in PMC

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