Iyer Ramesh Parameswara, Thalakkattoor Fessy Louis, Pillai Avani, Tharadevi Parvathy, Krishnan Sajitha, Nagaraj Aparna
Department of Reproductive Medicine and Surgery, IQRAA International Hospital and Research Centre, Kozhikode, Kerala, India.
Department of Reproductive Medicine and Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
J Hum Reprod Sci. 2021 Jan-Mar;14(1):42-48. doi: 10.4103/jhrs.JHRS_130_20. Epub 2021 Mar 30.
Advanced glycation end-products (AGEs) are toxic metabolic end-products of lipids, nucleic acids, and proteins. Their accumulation in the ovaries can alter the follicular microenvironment and affect stimulation response.
We aimed to study the association of AGEs in follicular fluid (FF AGE) with oocyte response and clinical pregnancy in ART-Assisted Reproductive Technology cycles.
This prospective study involved 84 individuals undergoing ART.
FF was collected during oocyte retrieval, and the level of AGEs was measured by enzyme-linked immunosorbent assay. Oocyte response was grouped as below target (<7 MII oocytes) or above target response (≥7 MII).
The association of FF AGE with the oocyte response and clinical pregnancy rate was analyzed by Mann-Whitney U-test. The strength of association of FF AGE with the outcome variables was analyzed with receiver operating characteristic (ROC) curve.
The median FF AGE was 17.6 (8.5) μg/ml. It was significantly higher in the below target than the normal ovarian response group (18.5 [17.8] vs. 16.3 [7.8] μg/ml, = 0.046). Similarly, it was significantly higher in those who did not conceive (19.9 [7.3] vs. 13.5 [5.9] μg/ml, < 0.001). The cutoff of FF AGE obtained by ROC curve analysis was 16.5 μg/ml above which there were significantly lower oocyte response and clinical pregnancy.
Elevated FF AGE can be a significant negative predictor of clinical pregnancy and ovarian response to stimulation in ART cycles. The FF AGE level above the cutoff value of 16.5 μg/ml was associated with significantly lower oocyte response and clinical pregnancy.
晚期糖基化终产物（AGEs）是脂质、核酸和蛋白质的有毒代谢终产物。它们在卵巢中的积累会改变卵泡微环境并影响刺激反应。
我们旨在研究卵泡液中AGEs（FF AGE）与辅助生殖技术（ART）周期中卵母细胞反应及临床妊娠之间的关联。
这项前瞻性研究纳入了84名接受ART的个体。
在取卵时收集卵泡液，采用酶联免疫吸附测定法测量AGEs水平。卵母细胞反应分为低于目标值（<7个MII卵母细胞）或高于目标反应（≥7个MII）。
采用Mann-Whitney U检验分析FF AGE与卵母细胞反应及临床妊娠率之间的关联。使用受试者工作特征（ROC）曲线分析FF AGE与结局变量的关联强度。
FF AGE的中位数为17.6（8.5）μg/ml。低于目标值组显著高于正常卵巢反应组（18.5 [17.8] vs. 16.3 [7.8] μg/ml，P = 0.046）。同样，未受孕者的FF AGE也显著更高（19.9 [7.3] vs. 13.5 [5.9] μg/ml，P < 0.001）。通过ROC曲线分析得到的FF AGE截断值为16.5 μg/ml，高于该值时卵母细胞反应和临床妊娠率显著降低。
卵泡液中AGEs升高可能是ART周期中临床妊娠和卵巢刺激反应的重要负性预测指标。FF AGE水平高于16.5 μg/ml的截断值与显著更低的卵母细胞反应和临床妊娠相关。
