The Library
Effect of in vitro fertilisation (IVF) hormonal therapy on metabolic, endocrine and inflammatory status in IVF-conceived pregnancy
Tools
Coussa, Ayla (2020) Effect of in vitro fertilisation (IVF) hormonal therapy on metabolic, endocrine and inflammatory status in IVF-conceived pregnancy. PhD thesis, University of Warwick.
|
PDF
WRAP_Theses_Coussa_2020.pdf - Submitted Version - Requires a PDF viewer. Download (2842Kb) | Preview |
Official URL: http://webcat.warwick.ac.uk/record=b3490074~S15
Abstract
Rationale: Infertility is the inability to conceive following 12 months of unprotected intercourse and affects 20% of couples worldwide. In vitro fertilisation (IVF) therapy has become more common in recent times. In mice, IVF associates with glucose intolerance. In humans, there is controversy regarding possible deleterious effects of IVF hormones in pregnancy, including worsening of metabolic, diabetogenic and inflammatory status.
Objectives: To explore effects of IVF therapy in pregnancy on glucose and lipid homeostasis, and other metabolic and inflammatory parameters. To explore early predictors of onset of gestational diabetes mellitus (GDM), including whether use of IVF therapy may hasten the onset of GDM.
Methodology: Adult non-diabetic women (n=275), BMI: 18.5-38kg/m2 , age ≤39years were recruited (n=158 pregnant, 117 non-pregnant). Collection of blood samples occurred throughout IVF cycle: baseline, 2, 4 and 12 weeks. Outcome variables included reproductive hormones, glucose, lipid profiles, insulin sensitivity, thyroid, gut microflora and inflammatory status.
Results: At 12 weeks, non-pregnant women experienced increased levels of glucose (86.04 to 87.62mg/dL), insulin (8.72 to 9.37µIU/mL), HOMA-IR (2.1 to 1.9), p<0.01; and lipid profile: T-Chol (169.5 to 174.9mg/dL), TG (71.0 to 83.7mg/dL), HDL-C (52.0 to 54.11mg/dL), with p<0.001. For pregnants, glucose (86.15 to 82.19mg/dL), HbA1c (5.3 to 5.08%) and TSH (1.71 to 1.36µIU/mL) were significantly lower and lipids were higher: TG (73.5 to 126.78mg/dL), T-Chol (177.5 to 199.5mg/dL), HDL-C (55.3 to 65.1mg/dL); all p<0.001. Prenatal BMI (OR=1.11; p<0.05) was the main predictor of GDM risk.
Conclusion: IVF therapy worsens lipid profile regardless of IVF outcome. Divergent effect of IVF therapy on glucose homeostasis depends on pregnancy status, with improved glycaemia in early IVF-conceived pregnancy, and worsened in the short term following unsuccessful IVF. The possible longer-term metabolic effects of IVF should be a focus for future research. Prenatal BMI appears to be the best predictor for future onset of GDM.
Item Type: | Thesis (PhD) | ||||
---|---|---|---|---|---|
Subjects: | R Medicine > RG Gynecology and obstetrics R Medicine > RM Therapeutics. Pharmacology |
||||
Library of Congress Subject Headings (LCSH): | Fertilization in vitro, Human, Hormone therapy -- Complications | ||||
Official Date: | April 2020 | ||||
Dates: |
|
||||
Institution: | University of Warwick | ||||
Theses Department: | Warwick Medical School | ||||
Thesis Type: | PhD | ||||
Publication Status: | Unpublished | ||||
Supervisor(s)/Advisor: | Barber, Thomas ; Haydar, Hasan | ||||
Format of File: | |||||
Extent: | xv, 148 leaves : color illustrations | ||||
Language: | eng |
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |
Downloads
Downloads per month over past year