Monday, February 22, 2016

Leptin as a biomarker in assisted reproductive cycles!


Leptin is an adipose tissue hormone regulating the food intake and energy production in humans, with a role in female reproductive functions. This hormone also plays a crucial role in animal and human studies conducted to elucidate the mechanism behind infertility in obese individual.



A review published in forthcoming issue of Human Reproduction Update  aims to provide a perspective of physiological role of leptin, the role it plays in human reproduction and its role as a prognostic predictor of IVF outcome. All the articles  published in PubMed till January 2015  with keywords: leptin, reproduction, infertility, IVF and controlled ovarian stimulation were included.



Human and animal studies showed that leptin levels communicate with CNS regarding the nutritional status. It plays a role in reproductive function by its direct action on ovaries and indirectly by its action on CNS.



The review also confirmed the earlier assumption that high leptin serum /or follicular fluid leptin concentrations have correlated negatively with cycle outcome.



It is seen that high follicular fluid leptin (FFL) levels were associated with abdominal obesity, insulin resistance, and a lower live birth rate after IVF-ICSI.  Many studies have associated high leptin levels with poor oocyte and embryo quality, resulting in poor IVF outcome.



Circulating leptin levels are strongly correlated with obesity, which is frequently associated with polycystic ovarian syndrome (PCOS), a major form of dysovulatory infertility in women, characterized by endocrine abnormalities such as hyperandrogenism and inappropriate LH secretion.



Thus it is seen that leptin plays an important role in nutritional status, energy production and reproduction mainly through its action on hypothalamic-pituitary-ovarian function. Further investigations are warranted to define its precise role at cellular and molecular levels in obesity, and insulin resistance on IVF-ICSI outcomes. Its role as biomarker in predicting the IVF outcome also seems promising but needs larger data before it is routinely used!





References: 

https://humupd.oxfordjournals.org/content/early/2015/12/08/humupd.dmv057.abstract 



http://www.ncbi.nlm.nih.gov/pubmed/25439803






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