Yıl: 2020 Cilt: 3 Sayı: 2 Sayfa Aralığı: 97 - 101 Metin Dili: İngilizce DOI: 10.32322/jhsm.667822 İndeks Tarihi: 28-01-2022

Effects of tryptophan, a precursor for melatonin, on IVF outcomes and Doppler parameters

Öz:
Aims: Melatonin is the most powerful antioxidant and protects sperm, oocyte, and embryo against oxidative stress. The effect of tryptophan, which is the building block of melatonin, on follicular melatonin levels and IVF outcomes is unknown. The objective of this study was to investigate the effect of tryptophan administration, a precursor for melatonin, on the levels of intrafollicular melatonin with the aim to reveal the correlation between tryptophan and the total number and quality of oocytes as well as clinical pregnancy rates. In addition, we aimed to examine the effect of melatonin increased by tryptophan on uterine and ovarian blood flow. Material and Method: Out of 103 patients who applied to Ondokuz Mayıs University Hospital, IVF clinic for IVF treatment, 51 patients were administered a 100 mg dose of tryptophan orally (Group A) and 50 control patients who were randomly selected did not receive tryptophan (Group B). Firstly, follicular melatonin levels were compared between Group A receiving tryptophan and Group B without tryptophan. Both groups were also compared according to the oocyte count, oocyte count, fertilized oocyte count, embryo count, and pregnancy rates, ultimately. In addition, all patients were measured for uterine and ovarian artery blood flow by vaginal ultrasound on the day of OPU. Results: There were no differences in age (32.16±3.82 years vs 33.06±4.44 years) (p=0.276), BMI (28.45±2.82 kg/m)2vs 28.15±3.03kg/ m2 (p=0.602) and peak estradiol levels (2451.69±469.75 pg/ml vs 2420.26±443.71 pg/ml) (p=0.73) between the groups. Group A exhibited high levels of melatonin in the follicular fluid with a mean value of 259.8 pg/ml, whereas Group B had 91.3 pg/ml (p<0.001). There were found significant differences in the oocyte count (9.08±3.22 vs 7.66±1.89) (p=0,008), mature oocyte count (7.2±2.8 vs 6.1±1.8) (p=0,021) and fertilized oocyte count (6.35±2.44 vs 5.28±1.69) between group A and group B. Pregnancy rates were higher in group A (35.3%). The pregnancy rate (30%) was lower in Group B, which did not receive tryptophan and had low melatonin levels in follicular fluid. However, there was no statistically significant difference. Uterine, ovarian artery systolic and diastolic blood flows of Group A were significantly lower than Group B (p<0.001). Conclusions: Administration of tryptophan to IVF patients significantly increases the level of melatonin in follicular fluid. The results demonstrate that high levels of melatonin in follicular fluid may increase oocyte count and quality although they do not significantly improve clinical pregnancy rates.
Anahtar Kelime:

Melatoninin kaynağı triptofanın IVF hastalarının sonuçlarına ve Doppler parametrelerine etkisi

Öz:
Amaç: Melatonin bilinen güçlü bir antioksidandır ve sperm, oosit ve embrioyu oksidatif strese karşı korur. Melatoninin yapı taşı olan triptofanın foliküler melatonin seviyesine ve IVF sonuçlarına etkisini bilinmemektedir. Bu çalışmada IVF tedavisinde melatonin prekürsörü olan triptofan desteğinin intrafolliküler melatonin seviyesine etkisini incelemek ve bunun oosit sayısı, oosit kalitesi nihayetinde klinik gebelik oranlarında yaptığı farklılığı araştırmak amaçlandı. Ayrıca triptofan desteği ile artan melatoninin uterin ve overiyan kan akımına etkisi amaçlandı. Gereç ve Yöntem: IVF tedavisi için Ondokuz Mayıs Üniversitesi Hastanesi IVF Kliniği’ne başvuran 103 hastadan 51 hastaya triptofan oral 100 mg verilirken (Grup A ); randomize seçilen 50 kontrol hastasına verilmedi (Grup B). Öncelikle triptofan alan Grup A ve almayan Grup B arasında foliküler melatonin seviyesi kıyaslandı. Yine her iki grup oosit sayısı, matür oosit sayısı, fertilize oosit ve embrio sayıları nihayetinde gebelik oranları açısından karşılaştırıldı. Ayrıca tüm hastaların OPU yapıldığı gün uterin ve overiyan arter kan akımları vajinal ultrasonografi ile ölçülüp kayıt edildi. Bulgular: Gruplar arasında yaş (32,16±3,82 yıl vs 33,06±4,44 yıl) (p=0,276), BMI (28,45±2,82 kg/m2vs. 28,15±3,03 kg/m2 ) (p=0,602), pik östradiol (2451,69±469,75 pg/ml vs 2420,26±443,71 pg/ml) (p=0,73) değerleri için fark yoktu. Grup A’da folikül sıvısındaki melatonin düzeyi yüksek olup ortalama değeri 259,8 pg/ml; Grup B’de 91,3 pg/ ml olarak elde edilmişti (p<0,001). Oosit sayısı(9,08±3,22 vs 7,66±1,89) (p=0,008), matür oosit sayısı (7,2±2,8 vs 6,1±1,8) (p=0,021), fertilize oosit sayısı (6,35±2,44 vs 5,28±1,69) (p=0,012) için grup A ve B arasında anlamlı farklılık görüldü. Yine Grup A’da gebelik oranları (%35,3) daha fazlaydı. Triptofan kullanmayan ve folikül sıvısında melatonin düzeyi düşük olan Grup B’de ise daha az gebelik(%30) elde edilmişti. Ancak bu fark istatistiksel olarak anlamlı değildi (p=0,723). Grup A’nın uterin, ovariyan arter sistolik ve diyastolik kan akımları Grup B’ye göre anlamlı derecede düşük izlendi (p<0,001). Sonuç: IVF hastalarına triptofan verilmesi follikül sıvısında melatonin seviyelerini önemli ölçüde arttırmaktadır. Bu sonuçlara göre foliküler sıvıdaki yüksek melatonin düzeyleri klinik gebelik oranlarını anlamlı ölçüde arttırmasa da oosit sayısı ve kalitesinin gelişmine olumlu destek sağlayabilir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA bıldırcın f, Çelik H, ozdemir a, Karlı P, AVCI B, Batıoğlu S (2020). Effects of tryptophan, a precursor for melatonin, on IVF outcomes and Doppler parameters. , 97 - 101. 10.32322/jhsm.667822
Chicago bıldırcın fatma devran,Çelik Handan,ozdemir ayse zehra,Karlı Pervin,AVCI Bahattin,Batıoğlu Sertaç Effects of tryptophan, a precursor for melatonin, on IVF outcomes and Doppler parameters. (2020): 97 - 101. 10.32322/jhsm.667822
MLA bıldırcın fatma devran,Çelik Handan,ozdemir ayse zehra,Karlı Pervin,AVCI Bahattin,Batıoğlu Sertaç Effects of tryptophan, a precursor for melatonin, on IVF outcomes and Doppler parameters. , 2020, ss.97 - 101. 10.32322/jhsm.667822
AMA bıldırcın f,Çelik H,ozdemir a,Karlı P,AVCI B,Batıoğlu S Effects of tryptophan, a precursor for melatonin, on IVF outcomes and Doppler parameters. . 2020; 97 - 101. 10.32322/jhsm.667822
Vancouver bıldırcın f,Çelik H,ozdemir a,Karlı P,AVCI B,Batıoğlu S Effects of tryptophan, a precursor for melatonin, on IVF outcomes and Doppler parameters. . 2020; 97 - 101. 10.32322/jhsm.667822
IEEE bıldırcın f,Çelik H,ozdemir a,Karlı P,AVCI B,Batıoğlu S "Effects of tryptophan, a precursor for melatonin, on IVF outcomes and Doppler parameters." , ss.97 - 101, 2020. 10.32322/jhsm.667822
ISNAD bıldırcın, fatma devran vd. "Effects of tryptophan, a precursor for melatonin, on IVF outcomes and Doppler parameters". (2020), 97-101. https://doi.org/10.32322/jhsm.667822
APA bıldırcın f, Çelik H, ozdemir a, Karlı P, AVCI B, Batıoğlu S (2020). Effects of tryptophan, a precursor for melatonin, on IVF outcomes and Doppler parameters. Journal of health sciences and medicine (Online), 3(2), 97 - 101. 10.32322/jhsm.667822
Chicago bıldırcın fatma devran,Çelik Handan,ozdemir ayse zehra,Karlı Pervin,AVCI Bahattin,Batıoğlu Sertaç Effects of tryptophan, a precursor for melatonin, on IVF outcomes and Doppler parameters. Journal of health sciences and medicine (Online) 3, no.2 (2020): 97 - 101. 10.32322/jhsm.667822
MLA bıldırcın fatma devran,Çelik Handan,ozdemir ayse zehra,Karlı Pervin,AVCI Bahattin,Batıoğlu Sertaç Effects of tryptophan, a precursor for melatonin, on IVF outcomes and Doppler parameters. Journal of health sciences and medicine (Online), vol.3, no.2, 2020, ss.97 - 101. 10.32322/jhsm.667822
AMA bıldırcın f,Çelik H,ozdemir a,Karlı P,AVCI B,Batıoğlu S Effects of tryptophan, a precursor for melatonin, on IVF outcomes and Doppler parameters. Journal of health sciences and medicine (Online). 2020; 3(2): 97 - 101. 10.32322/jhsm.667822
Vancouver bıldırcın f,Çelik H,ozdemir a,Karlı P,AVCI B,Batıoğlu S Effects of tryptophan, a precursor for melatonin, on IVF outcomes and Doppler parameters. Journal of health sciences and medicine (Online). 2020; 3(2): 97 - 101. 10.32322/jhsm.667822
IEEE bıldırcın f,Çelik H,ozdemir a,Karlı P,AVCI B,Batıoğlu S "Effects of tryptophan, a precursor for melatonin, on IVF outcomes and Doppler parameters." Journal of health sciences and medicine (Online), 3, ss.97 - 101, 2020. 10.32322/jhsm.667822
ISNAD bıldırcın, fatma devran vd. "Effects of tryptophan, a precursor for melatonin, on IVF outcomes and Doppler parameters". Journal of health sciences and medicine (Online) 3/2 (2020), 97-101. https://doi.org/10.32322/jhsm.667822