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Obese women exhibited altered ovarian follicular environment

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Results of a new study showed that obese women had higher levels of androgen activity, C-reactive protein and metabolite, and researchers said this altered ovarian follicular environment may result in poorer reproductive outcomes.

The researchers followed 96 women seeking assisted reproduction at a private clinic in South Australia between February 2006 and April 2007. The women were categorized into three groups based on BMI: moderate (n=33; BMI, 20-24.9); overweight (n=31; BMI, 25-29.9); and obese (n=32; BMI ≥30).

During the egg collection procedure, researchers collected measurements of hormone and metabolite levels in follicular fluid, and analyzed granulose and cumulus cells for mRNA expression of glucose-regulated genes (ChREBP, ACC, FAS), insulin-regulated genes (SREBP-1, CD36, SR-BI) and insulin-signaling components (IRS-2, Glut4) that were associated with insulin resistance and/or obesity.

The researchers reported an association with increasing BMI and increased C-reactive protein (P<.0001), triglycerides (P=.0003), follicular fluid insulin (P<.001) and lactate (P=.01); there was also an association present with decreased sex hormone-binding globulin (P=.001).

Compared with moderate weight women, BMI was not associated with insulin-signaling components (IRS-2, Glut4) or glucose-regulated genes, but insulin-regulated genes — specifically CD36 and SRBI — were modestly altered in the granulose cells of obese women.

“The systemic alterations associated with obesity extend directly into the ovarian follicular microenvironment,” the researchers concluded. However, further research is required to determine the effects on ovarian function and oocyte quality.

Robker RL. J Clin Endocrinol Metab. 2009; doi:10.1210/jc.2008-2648.