Biomarkers identification in follicular fluid of women with OHSS by using UPLC-MS method

Abstract

To figure out the differentially changed metabolites and disturbed pathways in follicular fluid (FF) of patients with OHSS in comparison to the control group undergoing in vitro fertilization (IVF), we conducted this metabolomic analysis between two groups, the OHSS group included 30 patients treated with oocyte retrieval and developed OHSS in the next 7-14 days, while another 30 patients without OHSS tendency were selected as the control group. The FF samples were obtained during the process of oocyte retrieval. FF samples were analyzed using ultra-high liquid chromatography-tandem mass spectrometry (UPLC-MS). The results identified a total of 59 differentially changed metabolites, including 33 decreased metabolites (P < 0.01) and 26 increased metabolites (P < 0.01) in FF of OHSS compared with the control group. 12 metabolites could be the most valuable biomarkers for OHSS based on ROC results. Our correlation analyses showed that deoxyinosine levels were found positively correlated with serum estradiol (E2) levels in OHSS patients, while L-isoleucine, pyruvic acid, maleamate, and arachidonic acid were found to be positively correlated with the number of retrieved oocytes. Furthermore, 4-hydroxyphenylacetaldehyde, deoxycorticosterone, creatinine, and creatine were found to be negatively associated with serum E2 levels, while 4-hydroxyphenylacetaldehyde, L-carnitine, isovaleric acid and L-2-hydroxyglutaric acid were negatively related with the number of oocytes retrieved in OHSS patients. Taken together, our study provides better identification of OHSS FF metabolic dynamics, suggesting the metabolic compounds can be used as valuable predictors or treatment targets of OHSS.

Metabolic landscape and pathogenic insights: a comprehensive analysis of high ovarian response in infertile women undergoing in vitro fertilization

“…Previous studies have highlighted significant differences in amino acid and lipid metabolites within the follicular fluid of OHSS patients compared to control groups [ 13 , 17 , 24 ]. Similarly, multiple lipid components in the serum or follicular fluid of PCOS patients exhibit alterations [ 25 , 26 ], particularly noticeable in obese individuals with PCOS, where lipid abnormalities are most pronounced [ 27 ].…”

“…Simultaneously, changes in maternal serum glutamic acid, aspartate, and 1-methylnicotinamide levels were significantly associated with improved symptoms in women with PCOS [ 12 ]. In cases of OHSS symptoms, researchers identified elevated follicular fluid levels of mannitol and pyruvate alongside decreased levels of L-carnitine and creatinine [ 13 ]. Additionally, investigations into women undergoing IVF revealed correlations between the majority of amino acids in serum and the number of mature oocytes [ 14 ].…”