Relationship Between Serum Polyunsaturated Fatty Acids and Pregnancy in Women Undergoing In Vitro Fertilization
Relationship Between Serum Polyunsaturated Fatty Acids and Pregnancy in Women Undergoing In Vitro Fertilization
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DOI：
10.1210/jc.2012-4115
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发表时间：
2013-08-01
影响因子：
5.8
通讯作者：
Riley, Joan K.
中科院分区：
文献类型：
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作者：
Jungheim, Emily S.;Frolova, Antonina I.;Riley, Joan K.
背景：多不饱和脂肪酸（PUFA）及其代谢对于正常的生殖功能和生育能力可能很重要。生理性 PUFA 与妊娠之间的关联尚未在女性中建立。目的：本研究的目的是调查接受体外受精 (IVF) 的女性血清 PUFA 水平与胚胎植入之间的关联。设计：这是一项 2010 年至 2012 年间进行的前瞻性队列研究。背景：该研究在华盛顿大学生殖医学中心进行。患者：参与者为 200 名接受 IVF 的女性，并参与正在进行的组织样本研究。银行.干预：用液相色谱-质谱法测量空腹血清PUFA。测量的 PUFA 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。主要结果指标：分析测量的 PUFA 血清水平与接受 IVF 的女性胚胎植入之间的关系。结果：在未经调整的分析中，没有一种单独的 PUFA 与怀孕机会相关；然而，与 LA:ALA 比率较低的女性相比，LA:ALA 比率较高的女性怀孕的机会较高（相对风险，1.52；95% 置信区间，1.09-2.13）。在对年龄、窦卵泡计数、体重指数、既往妊娠史和子宫内膜异位病史进行多变量逻辑回归调整后，这种关系仍然成立（比值比，2.7；95%置信区间，1.3-5.7）。胚胎着床率也与 LA:ALA 比率呈弱相关（r = 0.21，P = .003）。结论：我们的研究表明，接受 IVF 的女性中 omega-6 与 omega-3 PUFA 比率的增加与着床率和妊娠率的增加相关。需要进行前瞻性试验来确定通过饮食或药物干预控制多不饱和脂肪酸比例是否可能有益于计划怀孕的女性。
Context: 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.Objective: The purpose of this study was to investigate associations between serum levels of PUFAs and embryo implantation in women undergoing in vitro fertilization (IVF).Design: This was a prospective cohort study conducted between 2010 and 2012.Setting: The study was conducted at the Washington University Reproductive Medicine Center.Patients: Participants were 200 women undergoing IVF and participating in an ongoing specimen tissue bank.Intervention: Fasting serum PUFAs were measured with liquid chromatography-mass spectroscopy. PUFAs measured included linoleic acid (LA), a-linolenic acid (ALA), eicosapentaenoic acid, arachidonic acid, and docosahexaenoic acid.Main Outcome Measures: Relationships between serum levels of measured PUFAs and embryo implantation in women undergoing IVF were analyzed.Results: 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).Conclusions: Our work shows that increased omega-6 to omega-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.