Clinical significance of serum and follicular fluid ceramide levels in women with low ovarian reserve.

Objective: Ceramide (CER) is a bioactive component of the mitochondrial membrane. In this study, we will investigate the clinical importance of serum CER (sCER) and follicular fluid CER (ffCER) levels in the lipid synthesis pathway and their effect on poor oocyte quality and in vitro fertilization (IVF) outcome.

Materials and methods: This cross-sectional, case-control study was conducted in the IVF unit of a maternity hospital in the capital of Turkey, Ankara. A total of 88 women undergoing their first IVF cycle were included in this study patients were divided into 2 groups according to current diagnostic criteria for their ovarian reserves. Baseline sCER levels, and ffCER concentrations retrieved on the oocyte pickup day were measured.

Results: The mean age, body mass index, and infertility duration of the patients was similar between the groups (all p>0.05). There was also no significant difference in the clinical pregnancy rates (38.6% vs. 47.7%, p=0.127). sCER (15.6±6.5 vs. 23.5±8.9) and ffCER (82.5±34.3 vs. 116.4±46.5) levels were statistically significantly lower in the low ovarian reserve (LOR) group (both p<0.001). The performed receiver operating characteristic curve analysis revealed that sCER and ffCER levels could predict both LOR and pregnancy.

Conclusion: This is the first study evaluating the sCER and ffCER levels of patients undergoing IVF treatment. CER may be used as an ovarian reserve markers and a biomarker capable of predicting IVF outcomes.