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    Influência dos fatores femininos de infertilidade no estresse oxidativo do líquido folicular de pacientes submetidas a estímulo ovariano controlado
    (Universidade Federal de São Paulo (UNIFESP), 2014-04-15) Lima, Camila Bruna de [UNIFESP]; Lo Turco, Edson Guimaraes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: The present study aimed to evidence the oxidative status of follicular fluid from women submitted to in vitro fertilization treatments in order to establish a relationship between oxidative stress (OS) and the pathophysiology of different diseases like Polycystic Ovary Syndrome (PCOS) and Endometriosis. This study also aimed to correlate the OS with factors that may influence the success of assisted reproduction techniques such as the ovarian response to exogenous hormonal stimulation. Methods: This study included 183 patients referred to the Human Reproduction Service of Sao Paulo Hospital for in vitro fertilization treatments. They were separated according to the fertility factor to form the following groups: Controls (n=49), Endometriosis (n=48), Poor response (n=26), PCOS (n=15) e Hyper response (n=46). All patients were submitted to controlled ovarian hyper stimulation protocols and ovarian punction for follicular fluid collection. Results: The levels of oxidative stress were significantly higher in the groups Endometriosis (p=9,57x10-13), PCOS (p=0,00015) and Hyper response (p=7,04x10-7) when compared to Control group. In endometriosis group, it is possible to observe a positive correlation between FSH and LH serum levels (r=0,315 e p=0,031), and also between FSH and age (r=0,306 e p=0,035). It was not possible to find significant differences in OS levels on the comparison between Poor response and Control groups. (p=0,808). The moving average analysis showed a trend for increasing oxidative status with increasing age in patients who had hyper response to ovarian stimulation. It also showed a reduction in OS levels with increasing age in Endometriosis group. Pregnancy rates did not present statistically relevant differences among groups (p=0,381). Conclusions: In Endometriosis, PCOS and Hyper response groups, higher amounts of end products of lipid peroxidation were detected in follicular fluid. This highlights an elevated oxidative status in these patients. Moreover, the age seems to influence the levels of oxidative stress in Endometriosis and Hyper response groups. However, it was not possible to correlate oxidative stress with poor response or pregnancy rates.