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Barroso-Villa G, Valdespin-Fierro C, Weiser-Smeke AE, Machargo-Gordillo AP, Flores-Pliego A, Palma-Lara I, Oehninger S. Follicular fluid biomarkers for prediction of human IVF outcome in women with poor ovarian response. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2023. [DOI: 10.1186/s43043-023-00128-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Abstract
Background
The aim of controlled ovarian stimulation is to achieve an optimal number of mature oocytes to obtain good-quality embryos. High follicular fluid (FF) concentrations of FSH, hCG, and LH promote oocyte maturation and are associated with a higher probability of fertilization. LH concentrations in FF are consistently higher in follicles that will lead to a successful IVF outcome. The levels of some of these FF biomarkers may vary among different ovarian stimulation schemes; however, the effects of corifollitropin alfa, recombinant FSH (rFSH), LH (rLH), and highly purified urinary menotropins uhMG on these biomarkers are still unknown. The objective of this study was to characterize the profile of FF biomarkers (leptin, vascular endothelial growth factor (VEGF), metalloproteinases (MMPs), and NO2−/NO3−) according to three different protocols of controlled ovarian stimulation (COS) in poor ovarian responders (POR) and to evaluate the association between these profiles and clinical outcomes. Three groups of POR patients were examined according to the protocols used.
Results
Group C showed significant higher levels in all biomarkers (p < 0001). FF samples from Group B had the lowest levels of VEGF and Pro-MMP-9. Group A showed the lowest concentration of pro-MMP-2. The VEGF level and number of captured oocytes were positively correlated in Group C (r = 0.534, p = 0.01). MMP-9 and fertilization rate were negatively correlated in Group C (r = −0.476, p = 0.02). We found negative correlations between proMMP-2 and serum estradiol levels on the day of rhCG administration.
Conclusion
We found significant variations in the biomarker concentrations between the different controlled ovarian stimulation schemes used in POR patients. These differences can be potentially explained by the nature and composition of the gonadotropins. Our results support the hypothesis that some of these molecules should be thoroughly investigated as noninvasive predictors of egg quality.
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Huang X, Weng Z, Zhang S, Li X, Zhou S, Liang J. LC-MS/MS-based metabolomic profiling identifies candidate biomarkers in follicular fluid of infertile women with chronic pelvic inflammatory disease. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2023; 16:20-31. [PMID: 36910890 PMCID: PMC9993017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/13/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVES How chronic pelvic inflammatory disease (CPID), the most common cause of infertility, affects metabolic profiles of follicular fluid (FF) remains unknown. This study aimed to identify candidate biomarkers in FF of infertile women with CPID. METHOD FF samples were collected from infertile women with CPID (n = 8) and healthy controls (n = 8) at the time of oocyte retrieval. Untargeted metabolomic profiling of FF samples was conducted using the liquid chromatography-tandem mass spectrometry (LC-MS/MS). RESULTS A total of 240 differential metabolites (104 named biochemicals and 136 unnamed biochemicals) were screened out and identified. Among them, pregnane-3,3-diol, pc(p-18:1(11z)/18:3(6z,9z,12z)), and 1-octadecanoyl-2-(4z,7z,10z,13z,16z,19z-docosahexaenoyl)-sn-glycero-3-phosphoethanolamine were markedly down-regulated, while 17,21-dihydroxypregnenolone was significantly up-regulated in infertile women with CPID. Furthermore, KEGG biological pathway analysis revealed that these metabolites were especially enriched in steroid hormone biosynthesis, glyoxylate and dicarboxylate metabolism, glucagon signaling pathway, and the tricarboxylic acid (TCA) cycle. CONCLUSION FF of infertile women with CPID showed unique metabolic changes that may be involved in the pathogenesis of infertility and serve as new therapeutic targets or diagnostic biomarkers.
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Affiliation(s)
- Xuekun Huang
- Department of Reproductive Medicine, The First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou 510095, Guangdong, P. R. China
| | - Zhiwei Weng
- Department of Reproductive Medicine, The First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou 510095, Guangdong, P. R. China
| | - Shuting Zhang
- Department of Reproductive Medicine, The First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou 510095, Guangdong, P. R. China
| | - Xuerong Li
- Department of Reproductive Medicine, The First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou 510095, Guangdong, P. R. China
| | - Shaohu Zhou
- Department of Reproductive Medicine, The First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou 510095, Guangdong, P. R. China
| | - Jingyao Liang
- Department of Dermatology, Guangzhou Institute of Dermatology Guangzhou 510095, Guangdong, P. R. China
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Jakubczyk P, Paja W, Pancerz K, Cebulski J, Depciuch J, Uzun Ö, Tarhan N, Guleken Z. Determination of idiopathic female infertility from infrared spectra of follicle fluid combined with gonadotrophin levels, multivariate analysis and machine learning methods. Photodiagnosis Photodyn Ther 2022; 38:102883. [PMID: 35487430 DOI: 10.1016/j.pdpdt.2022.102883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/20/2022] [Accepted: 04/25/2022] [Indexed: 01/24/2023]
Abstract
By in vitro fertilization, oocytes can be removed and the embryo can be cultured, and then trans cervically replaced when they reach cleavage or when the blastocyst stage. The characterization of the follicular fluid is important for the treatment process. Women who applied to the Academic Hospital in vitro fertilization (IVF) Center diagnosed with idiopathic female infertility (IFI) were sought in the patient group. Demographics and clinical gonadotropin measurements of the study population were recorded. Of the 116 follicular fluid samples (n=58 male-induced infertility; n=58 control) were analyzed using the FTIR system. To identify FTIR spectral characteristics of follicular fluids associated with an ovarian reserve and reproductive hormone levels from control and IFI, six machine learning methods and multivariate analysis were used. To assess the quantitative information about the total biochemical composition of a follicular fluid across various diagnoses. FTIR spectra showed a higher level of vibrations corresponding to lipids and a lower level of amide vibrations in the IFI group. Furthermore, the T square plot from Partial Last Square (PLS) analysis showed, that these vibrations can be used to distinguish IFI from the control group which was obtained by principal component analysis (PCA). Proteins and lipids play an important role in the development of IFI. The absorption dynamics of FTIR spectra showed wavenumbers with around 100% discrimination probability, which means, that the presented wavenumbers can be used as a spectroscopic marker of IFI. Also, six machine learning methods showed, that classification accuracy for the original set was from 93.75% to 100% depending on the learning algorithm used. These results can inform about IFI women's follicular fluid has biomacromolecular differentiation in their follicular fluid. By using a safe and effective tool for the characterization of changes in follicular fluid during in vitro fertilization, this study builds upon a comprehensive examination of the idiopathic female infertility remodeling process in human studies. We anticipate that this technology will be a valuable adjunct for clinical studies.
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Affiliation(s)
| | - Wiesław Paja
- Institute of Computer Science, University of Rzeszów, Poland
| | - Krzysztof Pancerz
- Institute of Technology and Computer Science, Academy of Zamosc, Poland
| | | | - Joanna Depciuch
- Institute of Nuclear Physics Polish Academy of Science, 31-342 Krakow, Poland, Turkey.
| | - Özgur Uzun
- Istanbul University-Cerrahpaşa, Cerrahpasa Faculty of Medicine, Department of Histology and Embryology, Istanbul, Turkey
| | | | - Zozan Guleken
- Uskudar University, Faculty of Medicine, Department of Physiology, Istanbul Turkey.
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The Mechanism of Traditional Chinese Medicine Based on Semi-Targeted Metabolomics to Improve IVF Outcomes in Senile Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6696305. [PMID: 34804183 PMCID: PMC8598347 DOI: 10.1155/2021/6696305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 10/15/2021] [Indexed: 11/18/2022]
Abstract
Objective To identify the biological function and metabolic pathway of differential metabolites in follicular fluid of senile patients with kidney qi deficiency undergoing in vitro fertilization-embryo transfer (IVF-ET) and observe the effect of kidney-invigorating herbs on IVF outcomes in senile patients. Methods A total of 95 women undergoing IVF treatment were recruited and divided into three groups, including 34 cases in the treatment group (the senile patients with kidney qi deficiency after the intervention of Chinese medicine), 31 cases in the experiment group (the senile patients with kidney qi deficiency of no intervention of Chinese medicine), and 30 cases in the control group (young women with infertility due to male factor). The three groups of women were treated with long protocol ovarian hyperstimulation; the treatment group was given Qi-Zi-Yu-Si decoction on the day of HCG downregulation. Their IVF clinical outcomes were observed. The metabolites changes of kidney qi deficiency syndrome were analyzed in follicular fluid metabolomics using liquid chromatography-mass spectrometry (UPLC-MS/MS). Results The syndrome score of kidney qi deficiency syndrome in the treatment group was significantly improved after treatment (P < 0.01). Compared with the experiment group, the available embryo rate and implantation rate were increased, and the difference was statistically significant (P < 0.05). Progesterone, indoleacrylic acid, 2-propenyl 1-(1-propenylsulfinyl) propyl disulfide, N-acetyltryptophan, decanoylcarnitine, 20a-dihydroprogesterone, testosterone acetate, eicosatrienoic acid, 1H-indole-3-carboxaldehyde, choline, phosphorylcholine, and tryptophan were downregulated in the treatment group. Through pathway analysis, glycerophospholipid metabolism and steroid hormone biosynthesis were regulated in senile patients with kidney qi deficiency after Qi-Zi-Yu-Si decoction intervention. Conclusion Qi-Zi-Yu-Si decoction can effectively improve the IVF outcome and clinical symptoms of senile patients. Follicular fluid metabolites were significantly changed in senile infertile women with kidney qi deficiency, and the mechanism by which kidney-invigorating herbs improve IVF treatment outcomes may be related to glycerophospholipid metabolism and steroid hormone biosynthesis. This study was registered in the Chinese Clinical Trials Registry Platform (ChiCTR1800014422).
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Nagy B, Szekeres-Barthó J, Kovács GL, Sulyok E, Farkas B, Várnagy Á, Vértes V, Kovács K, Bódis J. Key to Life: Physiological Role and Clinical Implications of Progesterone. Int J Mol Sci 2021; 22:11039. [PMID: 34681696 PMCID: PMC8538505 DOI: 10.3390/ijms222011039] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/10/2021] [Accepted: 10/11/2021] [Indexed: 02/06/2023] Open
Abstract
The most recent studies of progesterone research provide remarkable insights into the physiological role and clinical importance of this hormone. Although the name progesterone itself means "promoting gestation", this steroid hormone is far more than a gestational agent. Progesterone is recognized as a key physiological component of not only the menstrual cycle and pregnancy but also as an essential steroidogenic precursor of other gonadal and non-gonadal hormones such as aldosterone, cortisol, estradiol, and testosterone. Based on current findings, progesterone and novel progesterone-based drugs have many important functions, including contraception, treatment of dysfunctional uterine bleeding, immune response, and prevention of cancer. Considering the above, reproduction and life are not possible without progesterone; thus, a better understanding of this essential molecule could enable safe and effective use of this hormone in many clinical conditions.
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Affiliation(s)
- Bernadett Nagy
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pécs, Hungary; (J.S.-B.); (G.L.K.); (E.S.); (B.F.); (Á.V.); (V.V.); (K.K.); (J.B.)
- Department of Obstetrics and Gynecology, Medical School, University of Pécs, 7624 Pécs, Hungary
- MTA-PTE Human Reproduction Scientific Research Group, University of Pécs, 7624 Pécs, Hungary
| | - Júlia Szekeres-Barthó
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pécs, Hungary; (J.S.-B.); (G.L.K.); (E.S.); (B.F.); (Á.V.); (V.V.); (K.K.); (J.B.)
- MTA-PTE Human Reproduction Scientific Research Group, University of Pécs, 7624 Pécs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
- Department of Medical Biology, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Gábor L. Kovács
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pécs, Hungary; (J.S.-B.); (G.L.K.); (E.S.); (B.F.); (Á.V.); (V.V.); (K.K.); (J.B.)
- Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
- Department of Laboratory Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Endre Sulyok
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pécs, Hungary; (J.S.-B.); (G.L.K.); (E.S.); (B.F.); (Á.V.); (V.V.); (K.K.); (J.B.)
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7624 Pécs, Hungary
| | - Bálint Farkas
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pécs, Hungary; (J.S.-B.); (G.L.K.); (E.S.); (B.F.); (Á.V.); (V.V.); (K.K.); (J.B.)
- Department of Obstetrics and Gynecology, Medical School, University of Pécs, 7624 Pécs, Hungary
- MTA-PTE Human Reproduction Scientific Research Group, University of Pécs, 7624 Pécs, Hungary
| | - Ákos Várnagy
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pécs, Hungary; (J.S.-B.); (G.L.K.); (E.S.); (B.F.); (Á.V.); (V.V.); (K.K.); (J.B.)
- Department of Obstetrics and Gynecology, Medical School, University of Pécs, 7624 Pécs, Hungary
- MTA-PTE Human Reproduction Scientific Research Group, University of Pécs, 7624 Pécs, Hungary
| | - Viola Vértes
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pécs, Hungary; (J.S.-B.); (G.L.K.); (E.S.); (B.F.); (Á.V.); (V.V.); (K.K.); (J.B.)
- Department of Obstetrics and Gynecology, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Kálmán Kovács
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pécs, Hungary; (J.S.-B.); (G.L.K.); (E.S.); (B.F.); (Á.V.); (V.V.); (K.K.); (J.B.)
- Department of Obstetrics and Gynecology, Medical School, University of Pécs, 7624 Pécs, Hungary
- MTA-PTE Human Reproduction Scientific Research Group, University of Pécs, 7624 Pécs, Hungary
| | - József Bódis
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pécs, Hungary; (J.S.-B.); (G.L.K.); (E.S.); (B.F.); (Á.V.); (V.V.); (K.K.); (J.B.)
- Department of Obstetrics and Gynecology, Medical School, University of Pécs, 7624 Pécs, Hungary
- MTA-PTE Human Reproduction Scientific Research Group, University of Pécs, 7624 Pécs, Hungary
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Steroid Hormones of Follicular Fluid and the Outcome of in Vitro Fertilization. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2021. [DOI: 10.2478/sjecr-2021-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
One of the succes factors of biomedically assisted fertilization is the regular maturation of one or more oocytes. The quality of the oocytes is significantly influenced by the environment in which it is located, the so-called „microenvironment” that includes cumulus cells, follicular fluid in which hormones and growth factors involved in its growth and development are secreted. The main aim was to examine whether the concentration of steroid hormones in the follicular fluid affects the rate of fertilization and the outcome of the in vitro fertilization process itself. The study included 31 patients who were included in vitro fertilization procedure at the Department for Biomedically Assisted Fertilization, Clinic for Gynecology and Obstetrics, Clinical Center Kragujevac. We used follicular fluid as biological material for analysis. Examination of the obtained follicular fluid and collection of oocytes under a stereomicroscope was done in the embryological laboratory at the Department. Biochemical parameters of follicular fluid were analyzed in the Department for Laboratory Diagnostics, Clinical Center Kragujevac. In vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) methods were used as the fertilization method. The criteria of the Istanbul Consensus of Clinical Embryologists were used as a reference framework for embryo quality assessment. Pregnancy was confirmed by a positive serum level of the hormone β-hCG 14 days after embryo transfer. A software package ЅРЅЅ 20 was used for statistical data processing. The results of the analysis of follicular fluid samples show that there was no statistically significant difference in the concentration of estradiol, progesterone and testosterone in follicular fluid in relation to fertilization rate and the outcome of in vitro fertilization. Based on our results, it can be concluded that the concentration of steroid hormones did not affect fertilization rate and the outcome of in vitro fertilization.
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Klobučar M, Pavlić SD, Car I, Severinski NS, Milaković TT, Badovinac AR, Pavelić SK. Mass spectrometry-based glycomic profiling of the total IgG and total proteome N-glycomes isolated from follicular fluid. Biomol Concepts 2020; 11:153-171. [PMID: 33099516 DOI: 10.1515/bmc-2020-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/11/2020] [Indexed: 11/15/2022] Open
Abstract
Couples with infertility issues have been assisted by in vitro fertilization reproduction technologies with high success rates of 50-80%. However, complications associated with ovarian stimulation remain, such as ovarian hyperstimulation. Oocyte quality is a significant factor impacting the outcome of in vitro fertilization procedures, but other processes are also critical for fertilization success. Increasing evidence points to aberrant inflammation as one of these critical processes reflected in molecular changes, including glycosylation of proteins. Here we report results from a MALDI-TOF-MS-based glycomic profiling of the total IgG and total proteome N-glycomes isolated from the follicular fluid obtained from patients undergoing fertilization through either (1) assisted reproduction by modified natural cycle or (2) controlled ovarian stimulation (GnRH antagonist, GnRH Ant) protocols. Significant inflammatory-related differences between analyzed N-glycomes were observed from samples and correlated with the ovarian stimulation protocol used in patients.
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Affiliation(s)
- Marko Klobučar
- University of Rijeka, Department of Biotechnology, Centre for high-throughput technologies, Radmile Matejčić 2, 51000 Rijeka, Croatia
| | - Sanja Dević Pavlić
- University of Rijeka, Department of Medical Biology and Genetics, Faculty of Medicine, B. Branchetta 20, 51000 Rijeka, Croatia
| | - Iris Car
- University of Rijeka, Department of Biotechnology, Centre for high-throughput technologies, Radmile Matejčić 2, 51000 Rijeka, Croatia
| | - Neda Smiljan Severinski
- Department of Obstetrics and Gynaecology, Clinical Hospital Centre Rijeka, Cambierieva 17/5, 51000 Rijeka, Croatia
| | - Tamara Tramišak Milaković
- Department of Obstetrics and Gynaecology, Clinical Hospital Centre Rijeka, Cambierieva 17/5, 51000 Rijeka, Croatia
| | - Anđelka Radojčić Badovinac
- University of Rijeka, Department of Biotechnology, Centre for high-throughput technologies, Radmile Matejčić 2, 51000 Rijeka, Croatia
- University of Rijeka, Department of Medical Biology and Genetics, Faculty of Medicine, B. Branchetta 20, 51000 Rijeka, Croatia
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LH supplementation of ovarian stimulation protocols influences follicular fluid steroid composition contributing to the improvement of ovarian response in poor responder women. Sci Rep 2020; 10:12907. [PMID: 32737326 PMCID: PMC7395161 DOI: 10.1038/s41598-020-69325-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 07/09/2020] [Indexed: 11/15/2022] Open
Abstract
In this prospective study, we evaluated the steroid levels in 111 follicular fluids (FF) collected from 13 women stimulated with FSH monotherapy and 205 FF collected from 28 women stimulated with FSH + LH because of a previous history of hypo-responsiveness to FSH. Steroid levels were measured by HPLC/MS–MS and related to ovarian stimulation protocol, oocyte maturity, fertilization and quality of blastocysts, after individually tracking the fate of all retrieved oocytes. 17-Hydroxy-Progesterone, Androstenedione, Estradiol and Estrone were significantly higher in the FSH + LH protocol. Progesterone, 17-Hydroxy-Progesterone and Estradiol were more expressed in FF yielding a mature oocyte (p < 0.01) in the FSH + LH protocol. FF Progesterone concentration was correlated with the rate of normal fertilization in the FSH protocol. None of the FF steroids measured were associated with blastocyst quality and achievement of pregnancy. Our results indicate that LH supplementation in hypo-responsive women modifies ovarian steroid production, mimicking physiological production better and likely contributing to an improved ovarian response. Employing a correct methodological procedure to evaluate the relationship between FF steroid hormones and assisted reproduction outcomes, our study reveals that some steroids in single follicles may be helpful in predicting oocyte maturity and fertilization.
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Pella R, Suárez-Cunza S, Orihuela P, Escudero F, Pérez Y, García M, Zorrilla I, Berrío P, Romero S. Oxidative balance in follicular fluid of ART patients of advanced maternal age and blastocyst formation. JBRA Assist Reprod 2020; 24:296-301. [PMID: 32159933 PMCID: PMC7365547 DOI: 10.5935/1518-0557.20200012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 01/06/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To evaluate the follicular fluid oxidative balance of infertile patients of advanced-maternal-age and the correlation between oxidative imbalance in the follicular fluid and the embryological outcomes. METHODS Follicular fluid (FF) from infertile patients of advanced-maternal-age undergoing ART treatments were collected and frozen in cryovials at -86°C until further use, and analyzed at the Biochemistry and Nutrition Institute of San Marcos University. As controls, we used FF from oocyte donors. The FF was then assayed for oxidative balance by ABTS, FRAP and TBARS assays. In order to establish the correlation between oxidative balance and embryo quality, we correlated the number of usable blastocysts (freshly transferred or frozen blastocysts) with the results from ABTS, FRAP and TBARS. RESULTS Follicular fluid from patients of Advanced-maternal-age (AMA group) significantly differed from the values found in the control group; the ABTS value was higher and the FRAP value was lower, in comparison to the FF from oocyte donors (control group). The lipid peroxidation was not different between those two groups. Furthermore, there was no significant correlation among the results of the assays, or when correlated with the proportion of usable blastocysts. CONCLUSION Ovarian oxidative balance seems to be critical for oocyte quality in advanced-maternal-age patients; however, we still need more studies on oxidative stress indicators, on a larger set of patients.
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Affiliation(s)
- Ricardo Pella
- Centro de Fertilidad y Reproducción Asistida CEFRA, Lima, Peru
| | - Silvia Suárez-Cunza
- Instituto de Bioquímica y Nutrición, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | | | - Ygor Pérez
- Centro de Fertilidad y Reproducción Asistida CEFRA, Lima, Peru
| | - Mario García
- Centro de Fertilidad y Reproducción Asistida CEFRA, Lima, Peru
| | - Ingrid Zorrilla
- Centro de Fertilidad y Reproducción Asistida CEFRA, Lima, Peru
| | - Paola Berrío
- Centro de Fertilidad y Reproducción Asistida CEFRA, Lima, Peru
| | - Sergio Romero
- Centro de Fertilidad y Reproducción Asistida CEFRA, Lima, Peru
- Laboratorio de Biología Reproductiva y Preservación de la Fertilidad, Universidad Peruana Cayetano Heredia, Lima, Peru
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Mitochondrial Function in Modulating Human Granulosa Cell Steroidogenesis and Female Fertility. Int J Mol Sci 2020; 21:ijms21103592. [PMID: 32438750 PMCID: PMC7279321 DOI: 10.3390/ijms21103592] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/04/2020] [Accepted: 05/18/2020] [Indexed: 02/07/2023] Open
Abstract
Ovarian follicle steroidogenesis associated with embryo quality results in a successful pregnancy. Each follicle consists of an oocyte surrounded by granulosa cells, which secrete several steroid and peptide hormones. Follicles harvested from women who conceived after assisted reproductive therapy (ART) had significantly higher estradiol levels in follicular fluids than the follicles from women who failed to conceive after ART. The higher follicular estradiol levels correlate well with successful fertilization following ART. Mitochondria are the central sites for steroid hormone biosynthesis. The first and rate-limiting step in the biosynthesis of steroid hormones occurs in the mitochondria of granulosa cells. In the present study, we hypothesized that the mitochondria in granulosa cells are critical for maintaining oocyte quality and fertility capacity. This study aims to clarify the relationship between mitochondrial function and granulosa cell steroidogenesis, and the relationship between hormone levels and fertility capacity. Sera, follicular fluids and granulosa cells were obtained from individuals undergoing IVF-ET treatment. The oocyte numbers, oocyte quality, fertilization rate, and pregnancy rate were also recorded. The patients who provided the granulosa cells were further classified into four groups: endometriosis, ovarian endometrioma, endometriosis without ovarian endometrioma, and polycystic ovary syndrome (PCOS); patients with other female factor infertility and male factor infertility were used as controls. We measured the levels of estradiol (E2) by radioimmunoassay. Concurrently, we analyzed the mitochondrial mass and membrane potential, and apoptosis by flow cytometry using nonyl acridine orange, TMRE, Annexin V-FITC and PI. Mitochondrial morphology was visualized by transfection with pLV-mitoDsRed. In addition, we assessed the protein levels of steroidogenic enzymes, steroidogenic acute regulatory protein (StAR) and 3β-hydroxysteroid dehydrogenase (3β-HSD) by Western blot. The results showed significantly decreased serum E2 and follicular E2 levels, and decreased IVF outcomes, in the patients with endometriosis. Reduced mitochondrial mass and decreased mitochondrial membrane potential were correlated with lower E2. Furthermore, a significant decrease in StAR and 3β-HSD was found in patients with ovarian endometrioma. The enzyme levels of StAR and 3β-HSD were highly correlated with E2 levels. Finally, elevated cumulus cell apoptosis was found in the patient group with ovarian endometrioma and PCOS. In conclusion, mitochondrial dysfunction of human granulosa cells may contribute to the decline of steroidogenesis, decreased fertilization rate, oocyte maturation rate, and oocyte quality, and it can ultimately jeopardize fertility.
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Seneda MM, Zangirolamo AF, Bergamo LZ, Morotti F. Follicular wave synchronization prior to ovum pick-up. Theriogenology 2020; 150:180-185. [PMID: 31982155 DOI: 10.1016/j.theriogenology.2020.01.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 01/12/2020] [Indexed: 11/28/2022]
Abstract
Among the reproductive biotechnologies, in vitro embryo production (IVEP) is an important tool for multiplying genetic material of superior merit. Recently, the number of embryos produced and transferred in vitro became significantly higher than that produced in vivo worldwide. In this context, the enhancement was attributable to ovum pick-up (OPU). With the advent of genomic technology, shortened breeding intervals, and increased selection accuracy, IVEP has attracted increasing attention for commercial use. The IVEP technique is well-established, but the embryo production rate has reached a plateau at 30-40%. Despite constant advances, the OPU/IVEP programs face some challenges that hinder the efficient application of the technique. Previous studies have shown that the quantity and quality of aspirated oocytes are essential factors for successful IVEP. This paper presents a brief overview of alternatives that can be employed to improve the process-seeking methods that assist in the recovery of better-quality oocytes and higher competence in OPU to improve embryo production. These strategies include using follicular wave synchronization prior to OPU, employing the influence of antral follicle populations, using the pre-OPU gonadotrophic stimulus and applying non-hormonal methods for selecting female donors.
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Affiliation(s)
- Marcelo Marcondes Seneda
- Universidade Estadual de Londrina, Laboratório de Reprodução Animal, DCV-CCA-UEL, Londrina, Parana, Brazil; National Institute of Science and Technology for Dairy Production Chain (INCT-LEITE), Universidade Estadual de Londrina, Rodovia Celso Garcia Cid-Campus Universitário, PO Box 10011, Londrina, Parana, 86057-970, Brazil.
| | - Amanda Fonseca Zangirolamo
- Universidade Estadual de Londrina, Laboratório de Reprodução Animal, DCV-CCA-UEL, Londrina, Parana, Brazil; National Institute of Science and Technology for Dairy Production Chain (INCT-LEITE), Universidade Estadual de Londrina, Rodovia Celso Garcia Cid-Campus Universitário, PO Box 10011, Londrina, Parana, 86057-970, Brazil
| | - Larissa Zamparone Bergamo
- Universidade Estadual de Londrina, Laboratório de Reprodução Animal, DCV-CCA-UEL, Londrina, Parana, Brazil
| | - Fábio Morotti
- Universidade Estadual de Londrina, Laboratório de Reprodução Animal, DCV-CCA-UEL, Londrina, Parana, Brazil
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12
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Nagy B, Poto L, Farkas N, Koppan M, Varnagy A, Kovacs K, Papp S, Bohonyi N, Bodis J. Follicular fluid progesterone concentration is associated with fertilization outcome after IVF: a systematic review and meta-analysis. Reprod Biomed Online 2019; 38:871-882. [DOI: 10.1016/j.rbmo.2018.12.045] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 12/20/2018] [Accepted: 12/23/2018] [Indexed: 12/18/2022]
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Dashti S, Aflatoonian A, Tabibnejad N. Comparison of Oocyte Maturation Trigger Using Follicle Stimulating Hormone Plus Human Chorionic Gonadotropin versus hCG Alone in Assisted Reproduction Technology Cycles. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2019; 13:102-107. [PMID: 31037919 PMCID: PMC6500079 DOI: 10.22074/ijfs.2019.5701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 12/02/2018] [Indexed: 11/23/2022]
Abstract
Background The goal of this study was to investigate oocyte maturation, fertilization and pregnancy rates among
infertile women, by concomitant follicle stimulating hormone (FSH) administration at the time of human chorionic
gonadotropin (hCG) trigger, compared to hCG trigger alone. Materials and Methods In this prospective randomized controlled trial, 109 infertile women between the ages of
20 and 40 years, received gonadotropin-releasing hormone (GnRH) antagonist and fresh embryo transfer. Following
the procedure, the subjects were randomly divided into two groups on the oocyte-triggering day. In the experimental
group, final oocyte maturation was achieved by 5000 IU hCG plus 450 IU FSH. In the control group, however, oocyte
triggering was performed by 5000 IU hCG, only. The primary outcome was clinical pregnancy and the secondary out-
comes included oocyte recovery rate, oocyte maturity rate, fertilization proportion rate, fertilization rate, implantation
rate and chemical pregnancy rate. Results Fifty-four women were appointed to the group with the FSH bolus injection at the time of hCG trigger and
55 women were assigned to the hCG alone group. Women in the FSH group had a significantly higher metaphase II
(MII) oocyte (7.17 ± 3.50 vs. 5.87 ± 3.19), 2 pronuclear embryos (2PNs) (5.44 ± 3.20 vs. 3.74 ± 2.30) and total em-
bryos (4.57 ± 2.82 vs. 3.29 ± 2.13) compared to hCG alone group, respectively. Furthermore, fertilization rate (0.75
± 0.19 vs. 0.68 ± 0.25), implantation rate (14.2 vs. 8.5%) as well as clinical (27.9 vs. 15.9%) and chemical (32.6 vs.
20.5%) pregnancy rates were higher in the FSH group, but no statistically significant difference was found (P>0.05). Conclusion Combination of FSH and hCG for oocyte triggering improves oocyte maturity and fertilization propor-
tion rates without increasing the chance of implantation, chemical and clinical pregnancy rates (Registration number:
IRCT2017082724512N5).
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Affiliation(s)
- Saeedeh Dashti
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abbas Aflatoonian
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Electronic Address:
| | - Nasim Tabibnejad
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Fuentes A, Sequeira K, Tapia-Pizarro A, Muñoz A, Salinas A, Céspedes P, Escalona J, Godoy A. Androgens Profile in Blood Serum and Follicular Fluid of Women With Poor Ovarian Response During Controlled Ovarian Stimulation Reveals Differences Amongst POSEIDON Stratification Groups: A Pilot Study. Front Endocrinol (Lausanne) 2019; 10:458. [PMID: 31379738 PMCID: PMC6646462 DOI: 10.3389/fendo.2019.00458] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 06/25/2019] [Indexed: 12/31/2022] Open
Abstract
Patients with poor ovarian response (POR) to exogenous gonadotropins stimulation for assisted reproductive technology (ART) have decreased circulating androgens during spontaneous cycles. The Patient-Oriented Strategies Encompassing Individualized Oocyte Number (POSEIDON) is a 4-tier stratification of women with POR to controlled ovarian stimulation (COH) based on age and biomarkers of ovarian reserve has been proposed to maximize the clinical management of this group for ART. The aim of the present study was to characterize the levels of androgens during COH in follicular fluid (FF) and serum in POSEIDON subgroups and compared them with women of normal ovarian response. Sixty nine consecutive patients undergoing ART were included and testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEA-S), estradiol, sex hormone-binding globulin (SHBG), and insulin-like growth factor 1 (IGF-1) were measured in serum and FF collected at the time of oocyte pick-up. The number of retrieved oocytes was registered for each patient for their allocation to the respective POSEIDON subgroup. The control group comprised 19 women and the POSEIDON group 1 (age < 35, normal ovarian reserve biomarkers) n = 14, group 2 (age ≥ 35, normal ovarian reserve biomarkers) n = 8, group 3 (age < 35, poor ovarian reserve biomarkers) n = 6 and group 4 (age ≥ 35, poor ovarian reserve biomarkers) n = 22. Serum levels of total testosterone, androstenedione and DHEA-S were not different in group 1 vs. control but significantly decreased in group 3 vs. control. DHEA-S in FF was also significantly decreased in group 3 vs. control. In addition, serum testosterone was decreased in groups 2 and 4 vs. control; and serum androstenedione and estradiol were reduced in group 4 vs. control. No differences were observed for estradiol, SHBG and IGF-1 in FF. Finally, a high correlation between serum and FF DHEA-S was observed when data from samples of all groups were pooled. Group 1 did not show hypoandrogenemia however group 3 had low levels of all measured androgens in serum and DHEA-S in FF. Such differences might help to better characterize and/or improve the clinical management of women with POR according to their respective POSEIDON stratification.
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15
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Walters KA, Eid S, Edwards MC, Thuis-Watson R, Desai R, Bowman M, Marren AJ, Handelsman DJ. Steroid profiles by liquid chromatography-mass spectrometry of matched serum and single dominant ovarian follicular fluid from women undergoing IVF. Reprod Biomed Online 2018; 38:30-37. [PMID: 30527851 DOI: 10.1016/j.rbmo.2018.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 10/19/2018] [Accepted: 10/23/2018] [Indexed: 10/27/2022]
Abstract
RESEARCH QUESTION Can IVF outcomes be predicted from the steroid profile generated by liquid chromatography-mass spectrometry (LC-MS/MS) from follicular fluid collected from a single dominant follicle and serum after ovarian stimulation. DESIGN Prospective observational cohort study in which serum and follicular fluid were collected from women and used to generate steroid profiles by LC-MS/MS. A total of 93 consecutive women enrolled for IVF treatment were recruited at the Fertility Unit, Royal Prince Alfred Women and Babies Hospital, Sydney between September 2014 and July 2015. Baseline and serum levels at oocyte retrieval, as well as follicular fluid samples from the largest single antral follicle, were collected. All samples underwent steroid analysis within a single batch to measure progesterone (P4), oestradiol (E2), oestrone (E1), dehydroepiandrosterone (DHEA), androstenedione (A4), testosterone (T), dihydrotestosterone (DHT), and 3 α, 5α androstanediol (3α-diol) and 3β, 5α androstanediol (3β-diol). RESULTS P4, E2, E1, A4, T, DHEA and A4 were detectable in all baseline serum levels, at oocyte retrieval and in follicular fluid samples, whereas DHT, 3α-diol and 3β-diol were only detectable in a minority of samples. The most consistent predictor of pre-transfer (number of follicles >14mm in diameter, oocytes retrieved or fertilized, day-5 blastocysts) outcomes was baseline serum anti-Müllerian hormone. In follicular fluid, E2 was a negative predictor of the number of oocytes retrieved and the number of day-5 blastocysts but no follicular fluid steroids predicted pregnancy outcome. CONCLUSIONS None of the nine steroids measured in follicular fluid predicted pregnancy outcome in women undergoing IVF.
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Affiliation(s)
- Kirsty A Walters
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW 2052, Australia.; Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales 2139, Australia..
| | - Stephanie Eid
- Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales 2139, Australia
| | - Melissa C Edwards
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW 2052, Australia.; Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales 2139, Australia
| | - Rachel Thuis-Watson
- Department of Reproductive Endocrinology and Infertility, Royal Prince Alfred Hospital for Women and Babies, Camperdown, NSW 2050, Australia.; Genea Fertility, Sydney, NSW 2000, Australia
| | - Reena Desai
- Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales 2139, Australia
| | - Mark Bowman
- Department of Reproductive Endocrinology and Infertility, Royal Prince Alfred Hospital for Women and Babies, Camperdown, NSW 2050, Australia.; Genea Fertility, Sydney, NSW 2000, Australia
| | - Anthony J Marren
- Department of Reproductive Endocrinology and Infertility, Royal Prince Alfred Hospital for Women and Babies, Camperdown, NSW 2050, Australia.; Genea Fertility, Sydney, NSW 2000, Australia
| | - David J Handelsman
- Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales 2139, Australia
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16
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Abbara A, Clarke SA, Dhillo WS. Novel Concepts for Inducing Final Oocyte Maturation in In Vitro Fertilization Treatment. Endocr Rev 2018; 39:593-628. [PMID: 29982525 PMCID: PMC6173475 DOI: 10.1210/er.2017-00236] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 06/27/2018] [Indexed: 01/20/2023]
Abstract
Infertility affects one in six of the population and increasingly couples require treatment with assisted reproductive techniques. In vitro fertilization (IVF) treatment is most commonly conducted using exogenous FSH to induce follicular growth and human chorionic gonadotropin (hCG) to induce final oocyte maturation. However, hCG may cause the potentially life-threatening iatrogenic complication "ovarian hyperstimulation syndrome" (OHSS), which can cause considerable morbidity and, rarely, even mortality in otherwise healthy women. The use of GnRH agonists (GnRHas) has been pioneered during the last two decades to provide a safer option to induce final oocyte maturation. More recently, the neuropeptide kisspeptin, a hypothalamic regulator of GnRH release, has been investigated as a novel inductor of oocyte maturation. The hormonal stimulus used to induce oocyte maturation has a major impact on the success (retrieval of oocytes and chance of implantation) and safety (risk of OHSS) of IVF treatment. This review aims to appraise experimental and clinical data of hormonal approaches used to induce final oocyte maturation by hCG, GnRHa, both GnRHa and hCG administered in combination, recombinant LH, or kisspeptin. We also examine evidence for the timing of administration of the inductor of final oocyte maturation in relationship to parameters of follicular growth and the subsequent interval to oocyte retrieval. In summary, we review data on the efficacy and safety of the major hormonal approaches used to induce final oocyte maturation in clinical practice, as well as some novel approaches that may offer fresh alternatives in future.
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Affiliation(s)
- Ali Abbara
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - Sophie A Clarke
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - Waljit S Dhillo
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, United Kingdom
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17
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Wang T, Xue B, Shao H, Wang SY, Bai L, Yin CH, Zhao HY, Qi YC, Cui LL, He X, Ma YM. Effect of Dandelion Extracts on the Proliferation of Ovarian Granulosa Cells and Expression of Hormone Receptors. Chin Med J (Engl) 2018; 131:1694-1701. [PMID: 29998889 PMCID: PMC6048925 DOI: 10.4103/0366-6999.235864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: In the current society, infertility related to age has become a social problem. The in vitro fertilization (IVF) success rate in women with poor ovarian response (POR) is very low. Dandelion extract T-1 (DE-T1) is an effective component of the extract from the leaves and stems of Taraxacum officinale, which is one of the medicines used in some patients with POR, but its molecular mechanism remains unclear. Methods: Following IVF, ovarian granulosa cells (GCs) of sixty patients were extracted and divided into normal ovarian response (NOR) and POR groups. GCs were cultured in a dose-dependent and time-dependent manner with DE-T1, proliferation of GCs was determined by Cell Counting Kit-8 assay, and mRNA levels of insulin-like growth factor 1 receptor (IGF-1R), luteotropic hormone receptor (LHR), follicle-stimulating hormone receptor (FSHR), LHR, and CYP19A1 (aromatase) were determined by quantitative polymerase chain reaction. Progesterone and estradiol (E2) concentrations were determined by enzyme-linked immunosorbent assay. Results: The cell viability gradually increased with the progressive increase in the DE-T1 concentration. Compared with the control group (without DE-T1), the mRNA expressions of FSHR, LHR, IGF-1R, and CYP19A1 were upregulated after the addition of DE-T1, especially in the 2.5% DE-T1 group (P < 0.01). The expression of IGF-1R was upregulated approximately 25 times (24.97 ± 4.02 times) in the POR group with 2.5% DE-T1. E2 and progesterone levels increased with the increasing DE-T1 concentration. There were highly significant differences in the E2 and progesterone secretion between the NOR and POR groups (P < 0.01). Conclusion: DE-T1 may promote steroid hormone synthesis by promoting GC proliferation and upregulating GC receptor expression, thereby improving ovarian endocrine function.
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Affiliation(s)
- Tong Wang
- Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Bing Xue
- Core Facility Center, Capital Medical University, Beijing 100069, China
| | - Hui Shao
- Hanabusa Women's Clinic, Tokujun Company, 4-2-15 Gokodori Chuo-Ku, Kobe, Hyogo, Japan
| | - Shu-Yu Wang
- Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Li Bai
- Hanabusa Women's Clinic, Tokujun Company, 4-2-15 Gokodori Chuo-Ku, Kobe, Hyogo, Japan
| | - Cheng-Hong Yin
- Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Huan-Ying Zhao
- Core Facility Center, Capital Medical University, Beijing 100069, China
| | - Yong-Chao Qi
- Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Le-Le Cui
- Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Xin He
- Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Yan-Min Ma
- Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
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18
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Inoue T, Yamashita Y, Tsujimoto Y, Yamamoto S, Taguchi S, Hirao K, Uemura M, Ikawa K, Miyazaki K. The association of follicular fluid volume with human oolemma stretchability during intracytoplasmic sperm injection. Clin Exp Reprod Med 2017; 44:126-131. [PMID: 29026718 PMCID: PMC5636924 DOI: 10.5653/cerm.2017.44.3.126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 07/21/2017] [Accepted: 08/17/2017] [Indexed: 12/04/2022] Open
Abstract
Objective Oocyte degeneration often occurs after intracytoplasmic sperm injection (ICSI), and the risk factor is low-quality oocytes. The follicular fluid (FF) provides a crucial microenvironment for oocyte development. We investigated the relationships between the FF volume aspirated from individual follicles and oocyte retrieval, oocyte maturity, oolemma stretchability, fertilization, and development. Methods This retrospective study included data obtained from 229 ICSI cycles. Ovarian stimulation was performed according to a gonadotropin-releasing hormone antagonist protocol. Each follicle was individually aspirated and divided into six groups according to FF volume (<1.0, 1.0 to <2.0, 2.0 to <3.0, 3.0 to <4.0, 4.0 to <5.0, and ≥5.0 mL). Oolemma stretchability during ICSI was evaluated using a mechanical stimulus for oolemma penetration, that is, the stretchability was assessed by oolemma penetration with aspiration (high stretchability) or without aspiration (low stretchability). Results Oocyte retrieval rates were significantly lower in the <1.0 mL group than in the ≥1.0 mL groups (46.0% [86/187] vs. 67.5%–74.3% [172/255 to 124/167], respectively; p<0.01). Low oolemma stretchability was significantly more common in the <1.0 mL group than in the ≥1.0 mL groups during ICSI (22.0% [13/59] vs. 5.8%–9.4% [6/104 to 13/139], respectively; p=0.018). There was a relationship between FF volume and oolemma stretchability. However, there were no significant differences in the rates of fertilization, cleavage, ≥7 cells at day 3, and blastocyst development among all groups. Conclusion FF volume is potentially associated with the stretchability of metaphase II oolemma during ICSI. Regarding oolemma stretchability, ensuring a uniform follicular size during ovarian stimulation is crucial to obtain good-quality oocytes.
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Affiliation(s)
- Taketo Inoue
- Umeda Fertility Clinic, Osaka, Japan.,Department of Emergency, Disaster and Critical Care Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | | | | | | | | | | | - Mikiko Uemura
- Faculty of Rehabilitation, Kobe Gakuin University, Kobe, Japan
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Sarhan D, El Mazny A, Taha T, Aziz A, Azmy O, Fakhry D, Torky H. Estradiol and luteinizing hormone concentrations in the follicular aspirate during ovum pickup as predictors of in vitro fertilization (IVF) outcome. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2017. [DOI: 10.1016/j.mefs.2016.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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20
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Kushnir MM, Naessén T, Wanggren K, Hreinsson J, Rockwood AL, Meikle AW, Bergquist J. Exploratory study of the association of steroid profiles in stimulated ovarian follicular fluid with outcomes of IVF treatment. J Steroid Biochem Mol Biol 2016; 162:126-33. [PMID: 26388251 DOI: 10.1016/j.jsbmb.2015.09.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 09/07/2015] [Accepted: 09/09/2015] [Indexed: 01/30/2023]
Abstract
Steroid concentrations in stimulated follicular fluid (sFF) samples have been linked to the quality of oocytes used in IVF treatments. Most of the published studies focused on evaluating the association of the IVF outcomes with only a few of the steroids, measured by immunoassays (IA). We performed a treatment outcome, prospective cohort study using stimulated FF sampled from 14 infertile women undergoing IVF treatment; single oocyte was used per IVF cycle. Fourteen endogenous steroids were analyzed in 22 ovarian follicle aspirations, which corresponded to the embryos used in the IVF. Ten oocytes were associated with live birth (LB) and 12 with no pregnancy (NP). Steroids were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods. Differences in distribution of concentrations in association with the pregnancy outcome (LB or NP), and receiver operating characteristic (ROC) curves analysis were performed for the entire cohort and for within-women data. The predominant androgen and estrogen in stimulated sFF were androstenedione (A4) and estradiol (E2), respectively. Lower concentrations of pregnenolone (Pr), lower ratios of A4/ dehydroepiandrosterone (DHEA), testosterone (Te)/DHEA, and greater ratios of E2/Te, and estrone/A4 were observed in sFF samples associated with LB. Among the oocytes associated with NP, in four out of 12 samples total concentration of androgens was above the distribution of the concentrations in the oocytes corresponding to the LB group. Observations of the study indicated increased consumption of precursors and increased biosynthesis of estrogens in the follicles associated with LB. Our data suggest that potentially steroid profiles in sFF obtained during oocyte retrieval may serve as biomarkers for selection of the best embryo to transfer after IVF.
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Affiliation(s)
- Mark M Kushnir
- ARUP (®) Institute for Clinical and Experimental Pathology, Salt Lake City, USA; Department of Pathology, University of Utah School of Medicine, Salt Lake City, USA; Analytical Chemistry/Department of Chemistry, Biomedical Center and SciLife Laboratory, Uppsala University, Uppsala, Sweden.
| | - Tord Naessén
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Kjell Wanggren
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | | | - Alan L Rockwood
- ARUP (®) Institute for Clinical and Experimental Pathology, Salt Lake City, USA; Department of Pathology, University of Utah School of Medicine, Salt Lake City, USA
| | - A Wayne Meikle
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, USA; Department of Medicine, University of Utah School of Medicine, Salt Lake City, USA
| | - Jonas Bergquist
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, USA; Analytical Chemistry/Department of Chemistry, Biomedical Center and SciLife Laboratory, Uppsala University, Uppsala, Sweden
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21
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Carpintero NL, Suárez OA, Varea CG, Rioja RG, Mangas CC. Variability between the follicular steroid hormone levels in different follicles of the same patient and between patients. J Hum Reprod Sci 2015; 8:37-42. [PMID: 25838747 PMCID: PMC4381381 DOI: 10.4103/0974-1208.153125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 03/04/2015] [Accepted: 02/27/2015] [Indexed: 02/05/2023] Open
Abstract
CONTEXT There is disagreement as to whether the concentration of a substance in follicular fluid is related to the quality of the follicle as a possible reflection of the oocyte quality or whether this concentration is related to the clinical characteristics of the patient. AIM To establish the variability of steroid hormone levels in follicular fluids from different follicles of the same patient and between patients. SETTINGS AND DESIGN Prospective cohort study. MATERIALS AND METHODS In 31 patients who underwent intracytoplasmic sperm injection it was performed an ultrasound guided aspiration of follicular fluid of the first two mature follicles from each ovary. Chemiluminescent microparticle immunoassays were performed to determine the levels of estradiol, progesterone, testosterone, and dehydroepiandrosterone sulfate (DHEA-S). STATISTICAL ANALYSIS Unconditional mixed model. RESULTS Variation in estradiol levels between follicles in the same patient was approximately twice the variation between subjects (P = 0.05). In the case of progesterone, the intra-subject variation was similar to the inter-subject variation (P = 0.006). The testosterone levels had a slightly smaller intra-subject variation than inter-subject variation (P = 0.002), and the intra-subject variation in DHEA-S levels was approximately one-fifth of the inter-subject variation (P = 0.0003). CONCLUSIONS The variations in the levels of follicular progesterone and testosterone were similar between patients and between a given patient's follicles; however, the estradiol levels variability was higher among different follicles. The amount of follicular estradiol may be considered a selection tool between the follicles of a given patient.
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Affiliation(s)
- Nayara López Carpintero
- Departments of Obstetrics, Gynaecology and Reproduction, La Paz University Hospital, Madrid, Spain
| | - Onica Armijo Suárez
- Departments of Obstetrics, Gynaecology and Reproduction, La Paz University Hospital, Madrid, Spain
| | - Carolina González Varea
- Departments of Obstetrics, Gynaecology and Reproduction, La Paz University Hospital, Madrid, Spain
| | | | - Carmen Cuadrado Mangas
- Departments of Obstetrics, Gynaecology and Reproduction, La Paz University Hospital, Madrid, Spain
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22
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Carpintero NL, Suárez OA, Mangas CC, Varea CG, Rioja RG. Follicular steroid hormones as markers of oocyte quality and oocyte development potential. J Hum Reprod Sci 2014; 7:187-93. [PMID: 25395744 PMCID: PMC4229794 DOI: 10.4103/0974-1208.142479] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 08/05/2014] [Accepted: 09/10/2014] [Indexed: 11/20/2022] Open
Abstract
CONTEXT: Various components of follicular fluid are suggested as biochemical predictors of oocyte quality. Previous studies of follicular steroid hormone levels have shown disparate results when related with fertilization outcomes. AIM: The objective of the study was to relate the levels of steroid hormones of each individual follicle with oocyte maturation, fertilization results, embryo quality, and pregnancy rates. SETTINGS AND DESIGN: Prospective cohort study in a university hospital. METHODS: In 31 patients, who underwent intracytoplasmic sperm injection, it was performed an ultrasound guided aspiration of follicular fluid of the first two mature follicles from each ovary. Follicular levels of estradiol, progesterone, testosterone, and dehydroepiandrosterone sulfate were measured by chemiluminescent immunoassay. STATISTICAL ANALYSIS: Generalized estimating equation model. RESULTS: In follicular fluids with mature oocyte presence, in normal as well as in failed fertilization, there was a positive correlation between follicular testosterone and progesterone (r = 0.794, P = 0.0001 and r = 0.829, P = 0.0001). Progesterone levels were higher in cases of normal fertilization compared to failed fertilization (P = 0.003). B quality embryos came from oocytes immersed in follicular fluids with higher estradiol values and higher estradiol/progesterone and estradiol/testosterone ratios than those of C quality (P = 0.01; P = 0.0009; P = 0.001). Estradiol levels were higher in patients who achieved pregnancy (P = 0.02). CONCLUSION: The analysis of follicular hormone composition could be considered as an additional tool in oocyte selection.
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Affiliation(s)
- Nayara López Carpintero
- Department of Obstetrics, Gynaecology and Reproduction, La Paz University Hospital, Paseo de la Castellana, Madrid, Spain
| | - Onica Armijo Suárez
- Department of Obstetrics, Gynaecology and Reproduction, La Paz University Hospital, Paseo de la Castellana, Madrid, Spain
| | - Carmen Cuadrado Mangas
- Department of Obstetrics, Gynaecology and Reproduction, La Paz University Hospital, Paseo de la Castellana, Madrid, Spain
| | - Carolina González Varea
- Department of Obstetrics, Gynaecology and Reproduction, La Paz University Hospital, Paseo de la Castellana, Madrid, Spain
| | - Rubén Gómez Rioja
- Department of Clinical Analyzes, La Paz University Hospital, Paseo de la Castellana, Madrid, Spain
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Thuesen LL, Andersen AN, Loft A, Smitz J. Intrafollicular endocrine milieu after addition of hCG to recombinant FSH during controlled ovarian stimulation for in vitro fertilization. J Clin Endocrinol Metab 2014; 99:517-26. [PMID: 24297796 DOI: 10.1210/jc.2013-1528] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The role of human chorionic gonadotropin (hCG) supplementation on the intrafollicular steroid milieu has been studied. OBJECTIVE The objective of the study was to assess the impact on steroid levels in follicular fluids (FFs) after different doses of hCG supplementation to recombinant FSH for controlled ovarian stimulation. SETTING This was a prospective randomized dose-response study conducted at Copenhagen University Hospital, Rigshospitalet, Denmark. PATIENTS From 62 in vitro fertilization patients, 334 FFs were selected for analyses. INTERVENTIONS Patients were treated using a GnRH agonist protocol with recombinant FSH 150 IU/d and randomized from stimulation day 1 to supplementation with hCG: D0, 0 IU/d; D50, 50 IU/d; D100, 100 IU/d; and D150, 150 IU/d. MAIN OUTCOME MEASURE Intrafollicular hormone concentrations in relation to treatment groups, follicular sizes, and embryo quality were measured. RESULTS In large follicles, hCG supplementation induced a nearly 3-fold increase of estradiol (nanomoles per liter) [D0: 1496; D50: 3138; D100: 4338; D150: 4009 (P < .001)], a significant 3-fold increase of androstenedione, and a 5-fold increase of T (nanomoles per liter) [D0: 15; D50: 38; D100: 72; D150: 56 (P < .001)]. The estradiol to T ratio decreased significantly, with the lowest ratio in D100 and the highest in D0. Large follicles giving rise to good-quality embryos had significantly higher estradiol and progesterone levels and estradiol to T, estradiol to androstenedione, and progesterone to estradiol ratios, compared with small follicles, leading to poor-quality embryos. CONCLUSIONS Increasing doses of hCG supplementation markedly stimulated the intrafollicular concentration of both estradiol and androgens, with a shift toward a more androgenic milieu. In large follicles with oocytes giving rise to good-quality embryos, the FFs were significantly more estrogenic than in small follicles with oocytes developing into poor quality embryos.
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Affiliation(s)
- L L Thuesen
- The Fertility Clinic (L.L.T., A.N.A., A.L.), Section 4071, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; and Follicle Biology Laboratory (J.S.), Vrije Universiteit Brussel, UZ Brussel, 1090 Brussels, Belgium
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FSH receptor in vitro modulation by testosterone and hCG in human luteinized granulosa cells. Eur J Obstet Gynecol Reprod Biol 2012; 165:259-64. [PMID: 22964136 DOI: 10.1016/j.ejogrb.2012.08.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 07/24/2012] [Accepted: 08/14/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the effect of testosterone and hCG on FSH receptor (FSHR) protein and mRNA expression in human granulosa cells (GC) in vitro. STUDY DESIGN Experimental in vitro cell culture obtained from healthy women undergoing IVF/ICSI due to male factor infertility. Human follicular fluid samples were obtained and after cumulus-oocyte complexes were identified, fluids were pipetted onto Ficoll gradients and centrifuged for 15 min at 400 × g at room temperature. Cells at the interface were removed and plated in 24-well plates for 3 days in M-199 with 10% FBS. Cells were treated with different concentrations of testosterone and hCG. After purification, cells were labeled with specific antibodies and the protein expression of the FSHR was evaluated by flow cytometry in the GC population. Also, total RNA was extracted from confluent GC and the FSHR gene expression was evaluated by RT-PCR. RESULTS FSHR expression was modulated by treating GC in vitro at different testosterone/hCG concentrations. When compared with untreated GC, we observed a significant effect of testosterone and hCG on the expression of the FSHR at the protein level. Time course experiments confirmed that the gene expression of the FSHR peaked at 12-24h when testosterone or hCG was used as a stimulus. CONCLUSIONS Both testosterone and hCG are able to positively modulate FSHR expression at gene and protein level in human GC in vitro.
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Lamb JD, Shen S, McCulloch C, Jalalian L, Cedars MI, Rosen MP. Follicle-stimulating hormone administered at the time of human chorionic gonadotropin trigger improves oocyte developmental competence in in vitro fertilization cycles: a randomized, double-blind, placebo-controlled trial. Fertil Steril 2011; 95:1655-60. [DOI: 10.1016/j.fertnstert.2011.01.019] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 12/07/2010] [Accepted: 01/06/2011] [Indexed: 10/18/2022]
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Lamb JD, Zamah AM, Rosen MP. Reply of the Authors: Follicular steroid hormone levels are associated with fertilization outcome after intracytoplasmic sperm injection. Fertil Steril 2011. [DOI: 10.1016/j.fertnstert.2010.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Verit FF, Sahin G, Tavmergen Goker EN, Hilali NG. Follicular steroid hormone levels are associated with fertilization outcome after intracytoplasmic sperm injection. Fertil Steril 2010; 95:e10; author reply e11. [PMID: 21144503 DOI: 10.1016/j.fertnstert.2010.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Accepted: 11/10/2010] [Indexed: 11/29/2022]
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