Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri 63105, USA.
J Clin Endocrinol Metab. 2013 Aug;98(8):E1364-8. doi: 10.1210/jc.2012-4115. Epub 2013 Jun 18.
Polyunsaturated fatty acids (PUFAs) and their metabolism may be important in normal reproductive function and fertility. Associations between physiologic PUFAs and pregnancy have not been established in women.
The purpose of this study was to investigate associations between serum levels of PUFAs and embryo implantation in women undergoing in vitro fertilization (IVF).
This was a prospective cohort study conducted between 2010 and 2012.
The study was conducted at the Washington University Reproductive Medicine Center.
Participants were 200 women undergoing IVF and participating in an ongoing specimen tissue bank.
Fasting serum PUFAs were measured with liquid chromatography-mass spectroscopy. PUFAs measured included linoleic acid (LA), α-linolenic acid (ALA), eicosapentaenoic acid, arachidonic acid, and docosahexaenoic acid.
Relationships between serum levels of measured PUFAs and embryo implantation in women undergoing IVF were analyzed.
In unadjusted analyses, none of the PUFAs alone were associated with a chance of pregnancy; however, women with increased LA:ALA ratios had a higher chance of pregnancy compared with women with lower LA:ALA ratios (relative risk, 1.52; 95% confidence interval, 1.09-2.13). This relationship held after multivariable logistic regression adjusting for age, antral follicle count, body mass index, history of previous pregnancy, and history of endometriosis (odds ratio, 2.7; 95% confidence interval, 1.3-5.7). Embryo implantation rates were also weakly associated with LA:ALA ratios (r = 0.21, P = .003).
Our work shows that increased ω-6 to ω-3 PUFA ratios in women undergoing IVF are associated with increased implantation and pregnancy rates. Prospective trials are needed to determine whether manipulation of PUFA ratios through diet or pharmacologic intervention may benefit women planning to conceive.
多不饱和脂肪酸（PUFAs）及其代谢可能在正常生殖功能和生育能力中发挥重要作用。尚未在女性中确定生理 PUFAs 与妊娠之间的关联。
本研究旨在调查行体外受精（IVF）的女性血清 PUFAs 水平与胚胎着床之间的关系。
这是一项于 2010 年至 2012 年进行的前瞻性队列研究。
研究在华盛顿大学生殖医学中心进行。
参与者为 200 名接受 IVF 并参与正在进行的标本组织库的女性。
用液相色谱-质谱法测量空腹血清 PUFAs。测量的 PUFAs 包括亚油酸（LA）、α-亚麻酸（ALA）、二十碳五烯酸、花生四烯酸和二十二碳六烯酸。
分析行 IVF 的女性血清中测量的 PUFAs 水平与胚胎着床之间的关系。
在未调整的分析中，单独的 PUFAs 均与妊娠机会无关；然而，LA：ALA 比值较高的女性妊娠机会高于 LA：ALA 比值较低的女性（相对风险，1.52；95%置信区间，1.09-2.13）。这种关系在调整年龄、窦卵泡计数、体重指数、既往妊娠史和子宫内膜异位症史后的多变量逻辑回归中仍然存在（比值比，2.7；95%置信区间，1.3-5.7）。胚胎着床率也与 LA：ALA 比值呈弱相关（r = 0.21，P =.003）。
我们的工作表明，行 IVF 的女性中 ω-6 至 ω-3 PUFAs 比值增加与着床率和妊娠率增加相关。需要前瞻性试验来确定通过饮食或药物干预改变 PUFAs 比值是否对计划怀孕的女性有益。
