Follicular Fluid Cerebellin And Betatrophin Regulate The Metabolic Functions Of Growing Follicles In Polycystic Ovary Syndrome

Objective: The aim of this study was to assess the changes of follicular fluid (FF) and serum levels of cerebellin precursor protein 1 (cbln1) and betatrophin in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) with a gonadotropin-releasing hormone (GnRH) antagonist protocol.Methods: Twenty infertile women with PCOS and 20 control women diagnosed as poor responders undergoing ovarian stimulation with a GnRH antagonist were included. Blood samples were obtained during ovum pick-up. Follicular fluid from a dominant follicle was collected from the subjects. Using enzyme-linked immunosorbent assays, FF and serum levels of cblnl and betatrophin were measured in both groups of participants. Metabolic and hormonal parameters were also determined and correlated with each other.Results: Both groups of women had similar serum and FF betatrophin levels (55.0 +/- 8.9 ng/mL vs. 53.1 +/- 10.3 ng/mL, p = 0.11). The serum and FF betatrophin levels of poor responders were found to be similar (49.9 +/- 5.9 ng/mL vs. 48.9 +/- 10.7 ng/mL, p = 0.22). Conversely, the FF cbln1 levels of PCOS women were found to be significantly higherthan the serum cbln1 levels (589.1 +/- 147.6 ng/L vs. 531.7 +/- 743 ng/L, p < 0.02).The FF cbln1 levels of control participants without PCOS were significantly higher than their serum cbln1 levels (5993 +/- 211.5 ng/L vs. 5253 +/- 87.0 ng/L, p = 0.01). Positive correlations were detected among body mass index, insulin resistance, serum insulin, total testosterone, and betatrophin levels in the PCOS group.Conclusion: Follicular fluid betatrophin and cbln1 concentrations may playa pivotal role on follicular growth in PCOS subjects undergoing IVF/ICSI with an antagonist protocol.