Circulating leptin levels during ovulation induction: relation to adiposity and ovarian morphology

Objective: To assess serum leptin levels based on body habitus and ovarian morphology during controlled ovarian hyperstimulation. Design: Prospective analysis. Setting: University IVF program. Patient(s): Women undergoing IVF-ET were divided into two groups, obese ovu latory women (n = 6; mean (+/-SD) body mass index, 30.1 +/- 0.6 kg/m(2)) an d lean ovulatory women (n = 20); mean (+/- SD) body mass index 22.0 +/- 0.2 kg/m(2)). Lean women were categorized further according to whether they ha d polycystic-appearing ovaries (n = 8) or normal-appearing ovaries (n = 12) . Intervention(s): Controlled ovarian hyperstimulation and IVF. Main Outcome Measure(s): Serum estradiol, testosterone, and leptin. Result(s): Mean (+/- SD) leptin levels were significantly higher before and after GnRH agonist downregulation in obese women (41.7 +/- 5.2 pg/mL and 3 6.1 +/- 5.8 pg/mL, respectively) compared with lean women (8.4 +/- 1.0 pg/m L and 6.9 +/- 1.1 pg/mL, respectively). Mean (+/- SD) leptin levels increas ed significantly in both groups (54.5 +/- 5.1 pg/mL and 11.7 +/- 1.2 pg/mL, respectively), and the mean (+/-SD) percentage increase was similar (55% /- 18% and 54.8% +/- 17%, respectively). Mean (+/-SD) leptin levels were si milar in women with polycystic-appearing and normal-appearing ovaries befor e controlled ovarian hyperstimulation, but increased significantly in women with polycystic-appearing ovaries afterward (14.7 +/- 1.8 pg/mL and 9.3 +/ - 1.0 pg/mL, respectively). Conclusion(s): Significant increases in leptin levels occur during controll ed ovarian hyperstimulation, suggesting that leptin plays a role in follicu lar growth and maturation. The exaggerated response in women with polycysti c-appearing ovaries reflects either a greater number of recruited follicles or a predisposition of adipocytes to leptin production. (C) 2000 by Americ an Society for Reproductive Medicine.