Feng Yifan, Qi Jia, Xue Xinli, Li Xinyu, Liao Yu, Sun Yun, Tao Yongzhen, Yin Huiyong, Liu Wei, Li Shengxian, Huang Rong
Department of Endocrinology and Metabolism, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Center for Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Reproduction. 2022 May 23;164(1):1-8. doi: 10.1530/REP-22-0023.
Polycystic ovary syndrome (PCOS) is a common cause of anovulatory infertility in women. This study identified changes in free fatty acids profiles in the follicular fluid that may lead to better diagnosis and management of infertility in PCOS women.
Polycystic ovary syndrome (PCOS) is a heterogeneous disease characterized by various endocrine/metabolic disorders and impaired reproductive potential. Alterations in oocyte competence are considered potentially causative factors for infertility in PCOS women and analyzing the composition of follicular fluid in these patients may help to identify which changes have the potential to alter oocyte quality. In this study, free fatty acid metabolic signatures in follicular fluid were performed to identify changes that may impact oocyte competence in non-obese PCOS women. Sixty-four non-obese women (32 with PCOS and 32 age- and BMI-matched controls) undergoing in vitro fertilization were recruited. Embryo quality was morphologically assessed. Free fatty acid metabolic profiling in follicular fluid was performed using gas/liquid chromatography-mass spectrometry. Principal component analysis and orthogonal partial least squares-discriminant analysis models were further constructed. Nine free fatty acids and 24 eicosanoids were identified and several eicosanoids synthesized by the cyclooxygenase pathway were significantly elevated in PCOS patients compared to controls. The combination of PGE2, PGF2α, PGJ2, and TXB2 had an area under the curve of 0.867 (0.775-0.960) for PCOS discrimination. Furthermore, follicular fluid levels of PGE2 and PGJ2 were negatively correlated with high-quality embryo rate in PCOS patients (P < 0.05). Metabolomic analysis revealed that follicular fluid lipidomic profiles undergo changes in non-obese PCOS women, which suggests that identifying changes in important metabolic signatures may give us a better understanding of the pathogenesis of PCOS. Furthermore, elevated PGE2 and PGJ2 concentrations may contribute to impaired oocyte competence in non-obese PCOS patients.
多囊卵巢综合征（PCOS）是女性无排卵性不孕的常见原因。本研究确定了卵泡液中游离脂肪酸谱的变化，这可能有助于更好地诊断和治疗PCOS女性的不孕症。
多囊卵巢综合征（PCOS）是一种异质性疾病，其特征是各种内分泌/代谢紊乱和生殖潜能受损。卵母细胞能力的改变被认为是PCOS女性不孕的潜在致病因素，分析这些患者卵泡液的成分可能有助于确定哪些变化有可能改变卵母细胞质量。在本研究中，对非肥胖PCOS女性的卵泡液进行游离脂肪酸代谢特征分析，以确定可能影响卵母细胞能力的变化。招募了64名接受体外受精的非肥胖女性（32名PCOS患者和32名年龄及BMI匹配的对照）。对胚胎质量进行形态学评估。使用气相/液相色谱-质谱联用仪对卵泡液进行游离脂肪酸代谢谱分析。进一步构建主成分分析和正交偏最小二乘判别分析模型。鉴定出9种游离脂肪酸和24种类花生酸，与对照组相比，PCOS患者中由环氧化酶途径合成的几种类花生酸显著升高。PGE2、PGF2α、PGJ2和TXB2的组合对PCOS鉴别的曲线下面积为0.867（0.775-0.960）。此外，PCOS患者卵泡液中PGE2和PGJ2水平与高质量胚胎率呈负相关（P<0.05）。代谢组学分析表明，非肥胖PCOS女性的卵泡液脂质组谱发生了变化，这表明识别重要代谢特征的变化可能有助于我们更好地理解PCOS的发病机制。此外，PGE2和PGJ2浓度升高可能导致非肥胖PCOS患者卵母细胞能力受损。
