Department of Sciences, University of Basilicata, viale Ateneo Lucano 10, 85100, Potenza, Italy.
Center for Reproductive Medicine of "San Carlo" Hospital, via Potito Petrone, 85100, Potenza, Italy.
Arch Gynecol Obstet. 2020 Sep;302(3):741-751. doi: 10.1007/s00404-020-05609-z. Epub 2020 May 27.
The main goal of this retrospective cohort study is the assessment of the effects of administration of recombinant-hCG (r-hCG) versus urinary-hCG (u-hCG) on follicular fluid (FF) composition of women who underwent in vitro fertilization (IVF) treatments.
We selected 70 patients with infertility attributable to tubal diseases, unexplained infertility, and male factor. Metabolomics analysis of their FFs was performed by H nuclear magnetic resonance (H NMR) spectroscopy in combination with multivariate analysis to interpret the spectral data. Univariate statistical analysis was applied to investigate the possible correlations between clinical parameters and between clinical parameters and metabolites identified by NMR.
According to the type of hCG used, significant differences were detected in FFs of women with male factor and unexplained infertility, both in qualitative and quantitative terms, for some metabolites as cholesterol, citrate, creatine, β-hydroxybutyrate, glycerol, lipids, amino acids (Glu, Gln, His, Val, Lys) and glucose. No significant difference was observed in women with tubal diseases. Besides, the number of MII oocytes in the u-hCG-treated groups correlates positively with glutamate in tubal disease and with glycerol in unexplained infertility. In the r-hCG-treated groups, the number of MII oocytes correlates positively with lipid in tubal disease, positively with citrate and negatively with glucose in male infertility.
Metabolite composition of FF changes according to different type of hCG treatment and this can be related to oocyte development and subsequent outcome. According to the data of this study, different types of hCG should be used in relation to the diagnosis of infertility to obtain better results in inducing oocyte maturation in women undergoing IVF.
本回顾性队列研究的主要目的是评估给予重组人绒毛膜促性腺激素（r-hCG）与尿源性人绒毛膜促性腺激素（u-hCG）对接受体外受精（IVF）治疗的女性卵泡液（FF）成分的影响。
我们选择了 70 名因输卵管疾病、不明原因不孕和男性因素导致不孕的患者。采用 H 核磁共振（H NMR）光谱结合多元分析对其 FF 进行代谢组学分析，以解释光谱数据。应用单变量统计分析来研究临床参数之间以及临床参数与 NMR 鉴定的代谢物之间的可能相关性。
根据 hCG 的类型，在男性因素和不明原因不孕的女性 FF 中，无论是定性还是定量，都检测到胆固醇、柠檬酸盐、肌酸、β-羟丁酸、甘油、脂质、氨基酸（Glu、Gln、His、Val、Lys）和葡萄糖等一些代谢物存在显著差异。在输卵管疾病患者中未观察到显著差异。此外，u-hCG 治疗组的 MII 卵母细胞数量与输卵管疾病中的谷氨酸呈正相关，与不明原因不孕中的甘油呈正相关。在 r-hCG 治疗组中，MII 卵母细胞数量与输卵管疾病中的脂质呈正相关，与男性不育中的柠檬酸盐呈正相关，与葡萄糖呈负相关。
根据不同类型 hCG 治疗，FF 的代谢物组成发生变化，这可能与卵母细胞发育和随后的结果有关。根据本研究的数据，在诱导接受 IVF 的女性卵母细胞成熟时，应根据不孕的诊断使用不同类型的 hCG，以获得更好的效果。
