Is There An Association between Dyslipidemia and The Risk of Ovarian Hyperstimulation Syndrome in A Population of Non-Obese Polycystic Ovary Syndrome Patients? A Cross-Sectional Study.

BACKGROUND

This research delves into exploring the nexus between lipid profiles and pro-inflammatory cytokines in both blood and follicular fluid (FF). It examines their impact on assisted reproductive technology (ART) outcomes and the propensity for ovarian hyperstimulation syndrome (OHSS) in non-obese polycystic ovary syndrome (PCOS) patients.

MATERIALS AND METHODS

One hundred and thirty-one PCOS patients with intracytoplasmic sperm injection (ICSI) indication, participated in this cross-sectional study. Based on plasma fasting lipids, patients were divided into two groups, dyslipidemia group (n=79) was defined as patients with triglyceride (TG) ≥150 mg/dl or/and total cholesterol (TC) ≥200 mg/dl. Patients with lower levels of lipids were included in the normal lipid group (n=51). All patients underwent the antagonist protocol to stimulate ovulation for ICSI. Blood and FF samples collected on the ovum pick-up (OPU) day. The concentrations of lipids in serum and FF, including TC and TG using Colorometry method, and also, high-density lipoprotein (HDL) using turbidimetric method. The lowdensity lipoprotein (LDL) level was calculated by the formula: LDL= TC-TG/5- HDL. Serum tumor necrosis factor-alpha (TNF-α) and interleukin-18 (IL-18) were measured with ELISA kit. ART outcomes encompassed retrieved oocytes, metaphase II oocytes (MII), and rates of fertilization, cleavage, blastocyst development, and chemical and clinical pregnancy.

RESULTS

FF level of LDL-C in the dyslipidemia group was markedly higher than the normal lipid group (P=0.007). Serum TNFα levels (P<0.001) and FF levels of TNF-α and IL-18 were significantly elevated in the dyslipidemia group (P=0.005, P<0.001, respectively). A robust correlation between FF inflammatory cytokines and ART outcomes emerged in PCOS patients, independent of lipid status. Notably, the normal lipid group exhibited a significantly higher risk of OHSS than the dyslipidemia group (P=0.034).

CONCLUSION

The present study underscored the association between lipid metabolic disorders in PCOS and heightened inflammatory cytokine levels, correlating with ART outcomes but not with OHSS risk.