Veterinary Physiology and Biochemistry, Department of Veterinary Sciences, University of Antwerp, 2610 Wilrijk, Belgium.
Hum Reprod. 2012 Dec;27(12):3531-9. doi: 10.1093/humrep/des350. Epub 2012 Sep 27.
Is the metabolic composition of the follicular fluid of women undergoing assisted reproductive treatment (ART) related to serum composition and BMI and is it associated with oocyte and embryo quality?
We showed that metabolic alterations in the serum are reflected in the follicular fluid and that some of these alterations may affect oocyte quality, irrespective of BMI.
Many studies have focused on the effect of metabolic disorders, such as obesity and type 2 diabetes, on assisted reproduction outcomes. There are, however, only few studies focusing on the importance of the correlation between serum and follicular fluid compositions and the composition of the follicular fluid as the oocyte's micro-environment, affecting its development and subsequent embryo quality.
DESIGN, PARTICIPANTS AND SETTING: In this prospective cohort study, patient information, fertility treatment outcome data, follicular fluid and serum were obtained from women undergoing ART. Patients were categorized according to their BMI (kg/m(2)) as normal (n = 60), overweight (n = 26) or obese (n = 20). Serum and follicular fluid samples were analyzed for urea, total protein, albumin, cholesterol, high-density lipoprotein cholesterol, triglycerides, non-esterified fatty acids, apolipoprotein A1, apolipoprotein B, glucose, lactate, C-reactive protein, insulin-like growth factor -1 (IGF-1), IGF-binding protein 3 (only in follicular fluid), free carnitine and total carnitine. Metabolite concentrations in serum and follicular fluid samples were correlated and were associated with BMI and fertility treatment outcome.
Most serum metabolite differences between patients were reflected in the follicular fluid (P < 0.05). Follicular fluid apolipoprotein A1 and follicular fluid total protein concentrations negatively affected oocyte quality parameters (P < 0.05). However, overall BMI-related associations were poor.
BIAS, CONFOUNDING AND OTHER REASONS FOR CAUTION: In this study, we included every patient willing to participate. Within this cohort, women with a BMI transcending 35 kg/m(2) were scarce (n = 2), because extremely overweight women are mostly advised to lose weight before starting ART. Furthermore, the number of patients in each BMI group was different, possibly masking associations between the metabolic composition of serum and follicular fluid and oocyte quality parameters.
There were significant associations indicating that metabolic changes in the serum are reflected in the follicular fluid, potentially affecting oocyte quality, irrespective of the patient's BMI. For ethical reasons, this study only focused on women already in need of artificial reproductive treatment. From a metabolic point of view, we consider this cohort as a representative sample of all women of reproductive age.
This study was funded by the special research fund, university of Antwerp (BOF UA). None of the authors has any conflict of interest to declare.
接受辅助生殖治疗（ART）的女性的卵泡液代谢成分与血清成分和 BMI 有关，是否与卵母细胞和胚胎质量有关？
我们表明，血清中的代谢变化反映在卵泡液中，其中一些变化可能会影响卵母细胞质量，而与 BMI 无关。
许多研究都集中在代谢紊乱（如肥胖和 2 型糖尿病）对辅助生殖结果的影响上。然而，只有少数研究关注血清和卵泡液成分之间的相关性以及卵泡液作为卵母细胞微环境的重要性，这会影响其发育和随后的胚胎质量。
设计、参与者和设置：在这项前瞻性队列研究中，从接受 ART 的女性中获取患者信息、生育治疗结果数据、卵泡液和血清。根据 BMI（kg/m2）将患者分为正常（n=60）、超重（n=26）或肥胖（n=20）。分析血清和卵泡液样本中的尿素、总蛋白、白蛋白、胆固醇、高密度脂蛋白胆固醇、甘油三酯、非酯化脂肪酸、载脂蛋白 A1、载脂蛋白 B、葡萄糖、乳酸、C 反应蛋白、胰岛素样生长因子-1（IGF-1）、IGF 结合蛋白 3（仅在卵泡液中）、游离肉碱和总肉碱。血清和卵泡液样本中的代谢物浓度相关，并与 BMI 和生育治疗结果相关。
患者之间的大多数血清代谢物差异都反映在卵泡液中（P<0.05）。卵泡液载脂蛋白 A1 和卵泡液总蛋白浓度对卵母细胞质量参数有负面影响（P<0.05）。然而，整体 BMI 相关关联较差。
偏倚、混杂因素和其他注意事项：在这项研究中，我们纳入了每一位愿意参与的患者。在这个队列中，BMI 超过 35kg/m2 的女性很少（n=2），因为超重的女性通常被建议在开始 ART 之前减肥。此外，每个 BMI 组的患者数量不同，这可能掩盖了血清和卵泡液代谢成分与卵母细胞质量参数之间的关联。
有显著的关联表明，血清中的代谢变化反映在卵泡液中，可能会影响卵母细胞质量，而与患者的 BMI 无关。出于伦理原因，本研究仅关注已经需要人工生殖治疗的女性。从代谢的角度来看，我们认为这个队列是所有育龄女性的代表性样本。
本研究由安特卫普大学特别研究基金（BOF UA）资助。所有作者均无利益冲突需要申报。
