Preliminary Screening Of Metabolites In Kidney-Deficiency And Blood-Stasis Syndrome Of Endometriosis And Its Relationship With Oocyte Quality

Objective To study metabolomics of follicular fluid in patients with endometriosis(EMT)with kidney-deficiency and blood-stasis syndrome undergoing IVF-ET by using ultra performance liquid chromatography-mass spectrometry(HPLC-MS).To identify the characteristic metabolites closely related to EMT of kidney deficiency and blood stasis,to analyze its effect on oocyte quality and to elucidate its mechanism.To provide ideas and methods for the improvement of the treatment outcome of assisted reproductive technology(ART)in EMT patients.Method A retrospective analysis of 55 cases of infertile patients with IVF clinical data,divided into two groups,of which 27 cases of observation group(due to female endometriosis),the control group of 28 cases(due to male factor).Follicular fluid was collected at the day of oocyte retrieval,and the changes of metabolites were analyzed.PCA and PLS-DA were used to analyze the samples intuitively,reliably and statistically as a whole,to find the markers and to interpret the marker attribution and metabolic network changes.The number of eggs,MII egg rate,normal fertilization rate,2PN cleavage rate,excellent embryo rate,cumulative pregnancy rate and live birth rate were compared between the two groups.Finally to look for the connection between the two cases.Result There were 28 metabolites,which were closely related to the developmental potentiality of oocytes and the markers of kidney deficiency and blood stasis syndrome.They are divided into four categories,including lipids,nucleotides,protein degradation fragments and others.There are up-regulated metabolites Valyl-Arginine,Methyl-15-cyanopentadecanoate,4-Oxo-13-cis-retinoate,Rhazidigenine Nb-oxide,Kinetensin1-3,2,4,14-Eicosatrienoic acid isobutylamide,LysoPC(18:(20: 3(5Z,8Z,11Z))DG(18: 2(9Z,12Z)/ 24: 1(15Z)/ 0: 0),LysoPC(18: 0)(D18: 1/22: 0),PC(o-18: 0/20: 4(8Z,11 Z,14Z,17Z)),PC(o-16: 0/22: 0),Glucosylceramide / 24: 1(15Z))TG(22: 5(7Z,10 Z,13Z,16 Z,19Z)/ 22: 0/22: 5(7Z,10 Z,13Z,16 Z,19Z));down-regulated metabolites LysoPC(16: 0),LysoPC(18: 1(9Z)),LysoPC(20: 4),Lyophil(20: 4),Lactobacillus plantarum,Lysozyme(20: 4),Lactobacillus plantarum,Lactobacillus plantarum,(18: 1(11Z)/ 24: 0/20: 5(5Z,8Z,11 Z,14Z)PA(16: 0e / 18: 0),CerP(d18: 1/26: 0),8Z,11 Z,14Z,17Z)).Conclusion Lysophosphatidylcholine,phosphatidylcholine,diglycerides and triglycerides,ether lipid metabolic intermediates,sphingolipid metabolites,menadione dibutyrate,4-oxo-9-cis-retinal AICAR and other 20 different metabolites may be potential candidate biomarkers for the maturation and fertilization of oocytes.Further study of these metabolites may help to reveal the molecular biological mechanism and provide new ideas for new clinical diagnosis,treatment,prognosis analysis and new drug development.And these 20 indicators in the endometriosis-related infertility,kidney and blood stasis and healthy women,follicular fluid metabolite expression results suggest potential related molecular markers of kidney-deficiency and blood-stasis syndrome;pentamylarginine,15-cyano pentadecane,Rhazidigenine Nb-oxide,vasopressin 1-3,2,4,14-eicosatriene Acid isobutyramide,imidazole acetic acid nucleotide,O-methylaflatoxin,2,4,14-eicosatrienoic acid isobutyramide has not yet found its specific mechanism of action,remains to be further studied.