High-resolution 1H-NMR spectroscopy indicates variations in metabolomics profile of follicular fluid from women with advanced maternal age.

AIM: To reveal whether there are differences in follicular fluid metabolomics profile of women with advanced maternal age (AMA). METHOD: The group with advanced maternal age includes 23 patients above the age of 40, and the control group includes 31 patients aged between 25 and 35 years and AMH values above 1.1 ng/mL with no low ovarian response history. A single follicular fluid sample from a MII oocyte obtained during the oocyte pick-up procedure was analyzed with high-resolution 1H-NMR (nuclear magnetic resonance) spectroscopy. The results were evaluated using advanced bioinformatics analysis methods. RESULTS: Statistical analysis of the NMR spectroscopy data from two groups showed that α-glucose and ß-glucose levels of follicular fluid were decreased in the patients with AMA, while in contrast, lactate and trimethylamine N-oxide (TMAO) levels were increased in these patients compared with the controls. In addition to these, there was an increase in alanine levels and a decrease in acetoacetate levels in patients with AMA. However, these changes were not statistically significant. CONCLUSION: Obtained results suggest that the follicular cell metabolism of patients with AMA is different from controls. These environmental changes could be associated with the low success rates of IVF treatment seen in these patients.

Metabolomics analysis of seminal plasma in patients with idiopathic Oligoasthenoteratozoospermia using high-resolution NMR spectroscopy.

BACKGROUND: Male infertility is a global health issue caused by a combination of different factors. Specialists generally rely on semen analysis to diagnose male infertility. However, it is known that diagnostic semen analysis fails to identify about 50% of male infertility disorders. Recently, metabolomics has been proven to be a powerful technique for the diagnosis of different diseases. OBJECTIVE: To determine whether metabolites could be used as potential biomarkers for the diagnosis of male factor infertility through comparing seminal plasma samples from infertile men with oligoasthenoteratozospermia (OAT) and samples from normozoospermic controls. MATERIALS AND METHODS: This study utilized high-resolution 1 H NMR spectroscopy to reveal whether the metabolomic changes of seminal plasma obtained from 31 patients with oligoasthenoteratozospermia (OAT) are different from the ones obtained from 28 normozoospermic controls. RESULTS: Multivariate statistical analysis of NMR data concluded that the metabolomic profile of samples from patients with OAT exhibits statistically significant differences when compared to the controls. The differences were based on the metabolites lactate, citrate, lysine, arginine, valine, glutamine, creatinine, α-ketoglutaric acid, spermine, putrescine, and tyrosine. Except the tyrosine, levels of the above metabolites were significantly decreased in patients with OAT compared to the controls. The levels of citrate, choline, spermine, putrescine, α-ketoglutaric acid, valine, and tyrosine were significantly different (p < 5 × 10-4 ) between two groups. On the other hand, levels of lactate, creatinine, lysine, arginine, and glutamine were also statistically significant (0.001 < p < 0.05). However, considering the p-values, the physiological relevance of these metabolites may be lower when compared to the others. A PLS-DA model built on the NMR data achieved 89.29% sensitivity and 93.55% specificity results in a leave-one-out cross-validation process. DISCUSSION AND CONCLUSION: 1 H NMR spectroscopy-based metabolomic analysis could be used as a diagnostic tool for the diagnosis of oligoasthenoteratozospermia.

The effect of pronuclear morphology on embryo quality parameters and blastocyst transfer outcome.

BACKGROUND: Embryo quality may be accurately assessed as early as the pronuclear zygote phase, as shown in recent studies. However, it is not known whether good quality zygotes are destined to become good quality cleavage stage embryos and blastocysts. METHODS: In this retrospective study, 86 intracytoplasmic sperm injection-embryo transfer cycles were studied where each available embryo was scored from the zygote until the blastocyst stage. Embryonic normality parameters such as pronuclear pattern, early cleavage, cleavage stage embryo grade, the presence of embryos with > or =8 cells on day 3 and blastocyst quality were recorded. Embryo transfer was undertaken at the blastocyst stage and the outcome was studied according to the pronuclear pattern exhibited by the zygotes. RESULTS: Embryos that showed an ideal pronuclear pattern (0 PN pattern) cleaved earlier and faster and resulted in better quality cleavage stage embryos and blastocysts. The incidence of blastocyst formation was 72% in zygotes showing a 0 PN pattern, compared with 12.7% in zygotes with double pronuclear abnormality. Higher implantation and pregnancy rates were obtained when at least one blastocyst derived from a 0 PN pattern zygote was included in the set of embryos to be transferred. CONCLUSIONS: Our results indicate that the pronuclear pattern of the zygote is closely related to blastocyst formation and quality. Blastocysts derived from 0 PN zygotes have a higher potential for implantation.

Relation between bone mineral content and clinical, hormonal and biochemical parameters in postmenopausal women.

We studied factors related to bone mass after a natural or surgical menopause in 73 healthy women attending the menopause clinic of a university hospital. In the natural menopause group we found inverse correlations between bone mineral density (BMD) vs. menopausal duration; BMD vs. body mass index (BMI) and BMI vs. inorganic phosphate (Pi), borderline correlations between weight vs. thyroxin (T4) and weight vs. luteinising hormone (LH) and a positive correlation between androstenedione (D4A) vs. urinary calcium (Uca). In the surgical menopause group we found some negative correlations (BMD vs. menopausal duration, BMI vs. Pi; BMI vs. dehydroepiandrosterone sulphate (DS), weight vs. DS and cortisol vs. Uca) and some positive correlations (BMD vs. free testosterone (fT), BMD vs. calcium (Ca), and BMD vs. Uca). We concluded that the serum hormone levels we measured were not useful markers of current bone mineral status.

Ovarian pregnancy; relationship to an intrauterine device.

Ovarian pregnancy is a rare form of ectopic pregnancy in which the gestational sac is implanted within the ovary. The incidence is 0.5 to 3% of all ectopic gestations. In contrast to patients with tubal pregnancies, traditional risk factors, such as pelvic inflammatory disease and prior surgical procedure upon the pelvis, may not play a role in the aetiology. In the 2 cases reported here, it seems that using an intrauterine contraceptive device was an important factor.

PIP: The etiology of primary ovarian pregnancy is unknown, although an IUD is frequently implicated. This paper presents two cases of primary ovarian pregnancy diagnosed at Dokuz Eylul University in Izmir, Turkey, in 1995 and discusses the pathogenesis in relation to the IUD. In the first case, the woman had used a copper-releasing IUD for 3 years and had had it removed 1 month before presentation. The second woman had been using a Lippes Loop device for 16 years. Ovarian pregnancy was diagnosed only after pathologic examination of the specimen. Both pregnancies were located within the corpus luteum, suggesting that fertilization and nidation occurred at the ovulation site. Although the IUD protects against ectopic pregnancy in the first 24 months of use, the risk increases over time as the reversible foreign-body histologic changes associated with IUD use become established in the Fallopian tube. The preoperative diagnosis of primary ovarian pregnancy is very difficult. It should be kept in mind, however, that ovarian pregnancy is more frequent in ectopic pregnancies associated with IUD use.

Umbilical coiling index: is it a marker for the foetus at risk?

The aim of this study was to determine the relationship between the number of coils in the umbilical cord and perinatal outcome. The umbilical cords and delivery records of 147 liveborn neonates were prospectively studied. The umbilical coiling index (UCI) of each cord was calculated by dividing the total number of complete umbilical vascular coils by the umbilical cord length. Subjects with UCIs below the 10th percentile, above the 90th percentile, and between the 10th and 90th percentiles were defined as hypocoiled, hypercoiled, and normocoiled, respectively. Several different parameters were used to measure neonatal outcome. The mean UCI was 0.20 +/- 10 (SD). No relationship was noted between UCI and maternal age, gravidity, parity, oligohydramnios, or birth weight. When we compared the hypocoiled group (n = 30) with the normocoiled group (n = 87), we detected a statistically significantly higher incidence of meconium staining, interventional delivery, apgar scores, fetal blood pH and intrapartum fetal heart rate disturbances. As a result, we concluded that the UCI has a strong relationship with perinatal outcome and may be used antenatally as a marker for identifying the fetus at risk.