The effect of environmental, physical, and nutritional factors on in vitro fertilisation

Cunningham, Thomas K.

Medicine
January 2016

Thesis or dissertation


Rights
© 2016 Thomas K Cunningham. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.
Abstract

Folliculogenesis, fertilisation and implantation of a human embryo requires unity of many different pathways. The literature review discusses folliculogensis, implantation and the potential affect that endocrine disrupting agents (EDAs) and Vitamin D can have on infertility and Polycystic Ovary Syndrome (PCOS). Can physical and immune-modulating treatments such as Endometrial scratching (ES) and intralipid aid in the treatment of recurrent implantation failure (RIF)?

EDAs were detected in the PCOS and controls, only the polyfluoroalkyl-agent (PFAA) perfluorooctane sulfonate (PFOS) had a significantly higher concentration in the PCOS group, (4.11±1.62 ng/ml vs. 3.11±1.05ng/ml, p=0.03). Whole group analysis showed PFAAs demonstrated significant positive correlations with testosterone. PFAAs, Polychlorinated Biphenyls and Dichlorodiphenyldichloroethylene (p,p-DDE) demonstrated significant positive correlations with cleavage rates (p=0.01 to 0.04), thus these chemicals may disrupt cell division in early embryo development. There was no correlation between EDAs and pregnancy in either group.

A pilot study was designed to see what effects Vitamin D levels had on IVF outcomes in PCOS and control subjects. A linear trend was observed between Vitamin D levels and fertilisation rates in the PCOS group suggesting a possible relationship between Vitamin D and oocyte maturation in this distinct population of women.

An observational study was designed to assess the effect of ES on women undergoing IVF. No increase in clinical pregnancy rates (p=0.54) was demonstrated in women with RIF, however clinical pregnancy rates were significantly reduced (p=0.04) in women undergoing their second cycle of IVF. These findings suggest that this treatment is not effective in the treatment of RIF.

The effect of intralipid to aid implantation in women with RIF has been postulated but not confirmed. A pilot study was designed to observe the effect of intralipid on NK-cell populations of women with RIF and controls undergoing IVF. The findings demonstrated no effect of intralipid on NK-cell populations in women with RIF.

Publisher
Hull York Medical School, The University of Hull and the University of York
Qualification level
Doctoral
Qualification name
MD
Language
English
Extent
2 MB
Identifier
hull:14051
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