The effect of adipose tissue StAR gene expression on ICSI among polycystic ovarian syndrome cases and matched controls: a case-control study

ABSTRACT

Objective. Steroidogenesis is vital for reproduction and fertility; it is governed by the acute regulatory protein gene (StAR). Earlier work discussed a different StAR expression in the adipose tissue (AT) of pregnant polycystic ovarian syndrome (PCOS) women. This study examined the correlation of StAR expression levels in AT of PCOS women to various parameters of intracytoplasmic sperm injection (ICSI) compared to those without.
Patients and Methods. A case-control study recruited 40 infertile women who had successful ICSI cycles into 2 groups: 20/40 cases and 20/40 non-PCOS cases; both groups were age and body mass index-matched for scheduled elective caesarean section. A sample of anterior abdominal wall AT was taken for a real-time PCR StAR gene expression. ICSI parameters, including hormonal, ultrasonic, stimulation drug doses and duration, and the outcome, were all retrospectively recorded and correlated with StAR gene expression.
Results. StAR gene folding was higher among PCOS-pregnant women (2.545 ± 1.58 vs 1.00 ± 0.0), P-value < 0.023. Estradiol hormone was correlated to StAR gene: -0.39, p < 0.05. The total doses of recombinant follicle-stimulating hormone and human menopausal gonadotropin had significant correlations to StAR gene r = -0.39, 0.60, P-value of 0.049, 0.005, respectively.
Conclusions. The significant association of StAR gene expression with stimulation drug doses suggests a clinical application, as it can reduce ovarian hyperstimulation syndrome and overall expense, which makes ICSI safer and more accessible to infertile couples. Women with PCOS present challenges in ICSI, and thus careful balance must be adjusted.