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.

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).

Conclusions: 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.