Journal of Family and Reproductive Health 2017. 11(2):74-81.

Level of Vitamin E in Follicular Fluid and Serum and Oocyte Morphology and Embryo Quality in Patients Undergoing IVF Treatment
Mohammad Hadi Bahadori, Seyedeh Hajar Sharami, Fereshteh Fakor, Forozan Milani, Davoud Pourmarzi, Seyedeh Fatemeh Dalil-Heirati


Objective: This study aimed to determine the relationship between vitamin E in the follicular fluid (FF) and serum with oocyte morphology and embryo quality.
Materials and methods: A cross-sectional study was conducted on serum samples, FF samples, oocytes, and embryos collected from 50 women undergoing in vitro fertilization in the Alzahra Hospital, Rasht, Iran from March to August 2014. Vitamin E level was measured using HPLC. Oocyte morphology and embryo quality were evaluated during inverted optical microscopy.
Results: Totally 434 oocytes and 199 embryos were examined. Most frequently the metaphase II (MII) oocytes were observed at the 0.35-1 mg/dl level of vitamin E in FF (89.2%) and the 1-5 mg/dl level of vitamin E in serum (86.1%). The odds of having MII oocytes at the level of 0.35-1 mg/dl (OR = 2.48, 95% CI = 1.24-4.94) and 1.5-2 mg/dl (OR = 2.51, 95% CI = 1.02-6.19) of vitamin E in FF was significantly higher compared to level of 2-7.4 mg/dl. The effect of vitamin E serum level on oocyte maturation was not significant. The odds of having embryo with Z1 or Z2 quality, at the 10-15 mg/dl level of vitamin E in serum (OR = 6.45, 95% CI = 1.18-35.22), compared to the 15-20 mg/dl level, was significantly higher. The effect of vitamin E levels in FF on the embryo quality was not significant.
Conclusion: At certain levels of vitamin E in the FF, oocytes with higher maturation and at certain levels of vitamin E in serum, embryo with higher quality can be achieved.


Vitamin E; Follicular Fluid; IVF; Oocyte Morphology; Embryo Quality

Full Text:



Kushnir VA, Vidali A, Barad DH, Gleicher N. The status of public reporting of clinical outcomes in assisted reproductive technology. Fertil Steril 2013;100:736-41.

Min JK, Breheny SA, MacLachlan V, Healy DL. What is the most relevant standard of success in assisted reproduction? The singleton, term gestation, live birth rate per cycle initiated: the BESST endpoint for assiste reproduction. Hum Reprod 2004;19:3-7.

Bourne H. Evolution of assisted reproductive technology as a treatment for male infertility. In: Cooke S, Fleming SD. Textbook of Assisted Reproduction for Scientists in Reproductive Technology. Australia: Vivid Publishing;2009:165.

Elder K, Dale B. In-vitro fertilization. Cambridge: Cambridge University Press; 2010.

Kruger TF, Menkveld R, Stander F, Lombard C, Van der Merwe J, Van Zyl J, et al. Sperm morphologic features as a prognostic factor in in vitro fertilization. Fertil steril 1986;46:1118-23.

Huang JYJ, Rosenwaks Z. In vitro fertilisation treatment and factors affecting success. Best Pract Res Clin Obstet Gynaecol 2012;26:777-88.

Dalal RJ, Mishra A. The Correlation between Follicular Fluid Antimullerian Hormone Levels and Fertilization and Embryo Quality in ART Cycles. Int J Infertility Fetal Med 2012;3:83-6.

Revelli A, Delle Piane L, Casano S, Molinari E, Massobrio M, Rinaudo P.Follicular fluid content and oocyte quality: from single biochemical markers tometabolomics. Reprod Biol Endocrinol 2009;7:40.

Borowiecka M, Wojsiat J, Polac I, Radwan M, Radwan P, Zbikowska HM. Oxidative stress markers in follicular fluid of women undergoing in vitro fertilization and embryo transfer. Syst Biol Reprod Med 2012;58:301-5.

Agarwal A, Gupta S, Sharma RK. Role of oxidative stress in female reproduction. Reprod Biol Endocrinol 2005 14;3:28.

Wong WY, Thomas CM, Merkus JM, Zielhuis GA, Steegers-Theunissen RP. Malefactor subfertility: possible causes and the impact of nutritional factors Fertil Steril 2000;73:435-42.

Agarwal A, Gupta S, Sikka S. The role of free radicals and antioxidants inreproduction. Curr Opin Obstet Gynecol 2006;18:325-32.

Aréchiga CF, Vázquez-Flores S, Ortíz O, Hernández-Cerón J, Porras A, McDowell LR,et al. Effect of injection of beta-carotene or vitamin E and selenium on fertility of lactating dairy cows. Theriogenology 1998;50:65-76.

Wang X, Falcone T, Attaran M, Goldberg JM, Agarwal A, Sharma RK. Vitamin C andvitamin E supplementation reduce oxidative stress-induced embryo toxicity andimprove the blastocyst development rate. Fertil Steril 2002;78:1272-7.

Scott L, Alvero R, Leondires M, Miller B. The morphology of human pronuclearembryos is positively related to blastocyst development and implantation. Hum Reprod 2000;15:2394-403.

Lan KC, Huang FJ, Lin YC, Kung FT, Hsieh CH, Huang HW, et al. The predictive value of using a combined Z‐score and day 3 embryo morphology score in the assessment of embryo survival on day 5. Hum Reprod2003;18:1299-306.

Boland MP, Lonergan P, O'Callaghan D. Effect of nutrition on endocrineparameters, ovarian physiology, and oocyte and embryo development.Theriogenology 2001;55:1323-40.

Miclea I, Pacală N, Hettig A, Zăhan M, Miclea V. Alpha-tocopherol and Ascorbic Acid Combinations Influence the Maturation of Sheep Oocytes. Scientific Papers Animal Science and Biotechnologies 2012;45:310-3.

Thiyagarajan B, Valivittan K. Ameliorating effect of vitamin E on in vitro development of preimplantation buffalo embryos. J Assist Reprod Genet 2009;26:217-25.

Biswas A, Mohan J, Sastry K. Effect of vitamin E on production performance and egg quality traits in Indian Native Kadaknath hen. Asian-Aust J Anim Sci 2010;23:396-400.

Olson S, Seidel G. Culture of in vitro-produced bovine embryos with vitamin E improves development in vitro and after transfer to recipients. Biol Reprod 2000;62:248-52.

Shariatzadeh SMA, Soleimanimehranjani M, Hamta A, Ghandizadehdezfuli M. The stereological study of the effect of vitamin E on the structure of ovary and its number of follicles during ovary development in rats treated with sodium arsenite. Arak Medical University Journal 2012;15:54-64.


  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.