Department of Animal Sciences and Aquatic Ecology, Ghent University, Coupure Links 653, 9000, Ghent, Belgium.
Department for Reproductive Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
Reprod Biol Endocrinol. 2022 Jul 25;20(1):107. doi: 10.1186/s12958-022-00974-7.
Advanced maternal age and obesity are associated with impaired female fertility. Moreover, fatty acids (FA) in follicular fluid (FF) play important roles in oocyte maturation and embryo development. However, the effects of body mass index (BMI), age, and FF FA composition on embryo development between days 3 and 5 and blastocyst stage on day 5 are still unclear.
This study included 138 patients undergoing assisted reproductive technology (ART), which were divided into three BMI groups (18.5-24.9 kg/m vs. 25.0-29.9 kg/m vs. ≥ 30.0 kg/m) and three age-related groups (20-30 years vs. 31-34 years vs. ≥ 35 years) which were compared for ART outcomes. Further, observations were divided into quartiles based on either of three parameters related to embryo outcome, i.e. (i) embryos developing between days 3 and 5 (ED3-5) and (ii) expanded blastocysts on day 5 (EB5), both expressed proportionally to the number of oocytes with two pronuclei (2PN), as well as (iii) the embryo utilization rate (EUR). Proportions of FF FA were then compared between Q1 and Q4, representing the quartile with the worst vs. the best embryo outcome, respectively. Finally, regression models were created to assess the relationships between BMI, age, FF total FA (TFA) concentration, relative proportions of specific FA and embryo outcome.
Patients of Q1 had higher proportions of FF C20:5n-3, C22:6n-3 and total n-3 PUFA than Q4 patients. Furthermore, Q4 patients tended to be younger than Q1 patients. Within the whole cohort, the proportion of C20:5n-3 negatively correlated with ED3-5/2PN and EUR, while EB5/2PN tended to be negatively correlated with age. Regression models within the overweight and obese group confirmed the negative relation between C20:5n-3 and ED3-5/2PN, but also indicated additional associations: C18:1n-9 and C20:4n-6 were positively associated with ED3-5/2PN and EUR, respectively while the proportion of C18:0 was negatively associated with EUR.
The proportions of n-3 PUFA, particularly C20:5n-3 and C22:6n-3 were reduced in the patients' quartile with the best embryo outcome. This group of patients was also younger. However, the embryo quality parameters of overweight/obese patients were not associated with age but were positively associated with FF C18:1n-9 and negatively with the proportions of C18:0 or C20:5n-3.
This study' registration number was B670201627735.
高龄和肥胖与女性生育能力受损有关。此外，卵泡液（FF）中的脂肪酸（FA）在卵母细胞成熟和胚胎发育中发挥重要作用。然而，BMI、年龄和 FF FA 组成对第 3 天至第 5 天胚胎发育以及第 5 天囊胚阶段的影响仍不清楚。
本研究纳入了 138 名接受辅助生殖技术（ART）的患者，他们分为三个 BMI 组（18.5-24.9kg/m2 组、25.0-29.9kg/m2 组和≥30.0kg/m2 组）和三个年龄相关组（20-30 岁组、31-34 岁组和≥35 岁组），比较各组 ART 结果。此外，根据与胚胎结局相关的三个参数（i）第 3 天至第 5 天发育的胚胎（ED3-5）和（ii）第 5 天扩展的囊胚（EB5），以及（iii）胚胎利用率（EUR）将观察结果分为四分位组，这三个参数均与具有两个原核（2PN）的卵母细胞数量成比例。然后比较 Q1 和 Q4 之间 FF FA 的比例，分别代表胚胎结局最差和最好的四分位组。最后，建立回归模型评估 BMI、年龄、FF 总 FA（TFA）浓度、特定 FA 的相对比例与胚胎结局之间的关系。
Q1 患者的 FF C20:5n-3、C22:6n-3 和总 n-3 PUFA 比例高于 Q4 患者。此外，Q4 患者的年龄比 Q1 患者小。在整个队列中，C20:5n-3 的比例与 ED3-5/2PN 和 EUR 呈负相关，而 EB5/2PN 与年龄呈负相关。超重和肥胖组内的回归模型证实了 C20:5n-3 与 ED3-5/2PN 之间的负相关关系，但也表明存在其他关联：C18:1n-9 和 C20:4n-6 分别与 ED3-5/2PN 和 EUR 呈正相关，而 C18:0 的比例与 EUR 呈负相关。
具有最佳胚胎结局的患者 FF 中 n-3 PUFA，特别是 C20:5n-3 和 C22:6n-3 的比例降低。这组患者也更年轻。然而，超重/肥胖患者的胚胎质量参数与年龄无关，而是与 FF C18:1n-9 呈正相关，与 C18:0 或 C20:5n-3 的比例呈负相关。
本研究的注册号为 B670201627735。
