Ko Yoo Ra, Kim Min Kyoung, Kim Ji Won, Han E Jung, Kim Se Jeong, Park Jae Kyun, Ahn So Yeon, Lee Minseo, Oh Surim, Hwang Sohyun, Kim Donghyeon, Lim Hyunjung Jade, Lee Woo Sik
Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea.
Department of Veterinary Medicine, Konkuk University, Seoul, Republic of Korea.
PLoS One. 2025 May 23;20(5):e0324511. doi: 10.1371/journal.pone.0324511. eCollection 2025.
Obesity negatively affects reproduction and in vitro fertilization (IVF) outcomes. However, its effects on lipid metabolism during embryonic development remain unclear. We examined follicular fluid (FF) lipid composition and body mass index (BMI)-related embryological outcomes in Korean women undergoing IVF/intracytoplasmic sperm injection (ICSI).
This prospective cohort study included 68 Korean women with infertility without metabolic diseases who underwent IVF/ICSI. Patients were categorized according to the 2022 guidelines of the Korean Society for the Study of Obesity as follows: Group A (obese, BMI ≥ 25 kg/m2, n = 28) and Group B (non-obese, BMI < 25 kg/m2, n = 40). Liquid chromatography-tandem mass spectrometry (LC-MS) was used to analyze lipids in the FF. Principal component analysis (PCA) and correlation analyses were performed. Embryological outcomes according to the BMI were compared using the QUADE nonparametric analysis of covariance adjusted for age and anti-Müllerian hormone.
LC-MS identified 159 of the 230 lipids in the FF samples. Diacylglycerol (DAG), triacylglycerol (TAG), and acylcarnitine (AC) levels were significantly higher in the obese group; whereas monoacylglycerol (MAG) and plasmenyl phosphatidylcholine levels were lower. PCA explained 38.9% of the variance between the groups. Significant inter-group differences were found in the DAG (adjusted p < 0.05) and AC 16:1 (adjusted p = 0.0139) levels. BMI and TAG, DAG, and AC levels (adjusted p < 0.05) were positively correlated. Obese group had fewer fertilized oocytes (5.07 ± 4.16 vs. 6.65 ± 4.61, p = 0.043), cleavage-stage embryos (4.86 ± 4.26 vs. 6.63 ± 4.61, p = 0.016), and morula-stage embryos (4.00 ± 4.51 vs. 6.05 ± 5.14, p = 0.024).
Obesity alters FF lipid composition in women with infertility undergoing IVF/ICSI, potentially affecting early embryonic development. This study improves our understanding of its effects on the ovarian microenvironment and offers insights into targeted IVF interventions.
肥胖对生殖及体外受精（IVF）结局有负面影响。然而，其对胚胎发育过程中脂质代谢的影响尚不清楚。我们研究了接受IVF/卵胞浆内单精子注射（ICSI）的韩国女性的卵泡液（FF）脂质成分及与体重指数（BMI）相关的胚胎学结局。
这项前瞻性队列研究纳入了68例无代谢疾病的韩国不孕女性，她们接受了IVF/ICSI。根据韩国肥胖研究学会2022年指南，将患者分为以下两组：A组（肥胖，BMI≥25 kg/m²，n = 28）和B组（非肥胖，BMI < 25 kg/m²，n = 40）。采用液相色谱 - 串联质谱法（LC-MS）分析FF中的脂质。进行主成分分析（PCA）和相关性分析。使用针对年龄和抗苗勒管激素进行协方差调整的QUADE非参数分析，比较不同BMI组的胚胎学结局。
LC-MS在FF样本的230种脂质中鉴定出159种。肥胖组中甘油二酯（DAG）、甘油三酯（TAG）和酰基肉碱（AC）水平显著更高；而单酰甘油（MAG）和缩醛磷脂酰胆碱水平较低。PCA解释了两组间38.9%的方差。在DAG（校正p < 0.05）和AC 16:1（校正p = 0.0139）水平上发现了显著的组间差异。BMI与TAG、DAG和AC水平呈正相关（校正p < 0.05）。肥胖组的受精卵母细胞较少（5.07 ± 4.16 vs. 6.65 ± 4.61，p = 0.043）、卵裂期胚胎较少（4.86 ± 4.26 vs. 6.63 ± 4.61，p = 0.016）和桑葚胚期胚胎较少（4.00 ± 4.51 vs. 6.05 ± 5.14，p = 0.024）。
肥胖会改变接受IVF/ICSI的不孕女性的FF脂质成分，可能影响早期胚胎发育。本研究增进了我们对其对卵巢微环境影响的理解，并为针对性的IVF干预提供了见解。
