Correlation Analysis Between The Contents Of AMH,BMP15,and TNF-α In Follicular Fluid Of Pcos Patients And Oocyte Quality

Objective To explore the correlation between the contents of anti-müllerian hormone(AMH),bone morphogenetic protein 15(BMP15),and tumor necrosis factor-alpha(TNF-α)in follicular fluid of patients with polycystic ovary syndrome(PCOS)and oocyte quality,and provide references for predicting embryo quality and in vitro fertilization-embryo transfer(IVF-ET)pregnancy outcomes in clinical work.Method Fifty-eight PCOS patients who met the diagnostic criteria for PCOS and received IVF-ET treatment due to infertility from February 2019 to October 2020 at the Reproductive Medicine Center of Linyi People’s Hospital were selected as the study group,including 28 PCOS patients with insulin resistance(IR-PCOS group)and 30 PCOS patients without insulin resistance(NIR-PCOS group).Thirty-four patients with tubal factor infertility and normal ovulation were selected as the control group.General information of the three groups was recorded,including age,number of retrieved oocytes,body mass index(BMI),basal hormone levels,duration of gonadotrophin(Gn)use,and Gn dosage.The evaluation indicators of oocyte quality were calculated,including oocyte maturation rate,normal fertilization rate,D3 high-quality embryo rate,and available blastocyst formation rate.The levels of AMH,BMP15,and TNF-α in the follicular fluid of the three groups were determined by double antibody sandwich enzyme-linked immunosorbent assay(ELISA),and the correlation between each detection index and oocyte quality was analyzed.The differences in various detection indicators in different pregnancy outcomes were also compared.SPSS 22.0 software was used for statistical analysis,and P < 0.05 indicated statistical significance.This study was approved by the hospital’s clinical ethics committee,and informed consent was obtained from all participants.Results(1)The body mass index(BMI)of IR-PCOS group was significantly higher than that of control group and NIR-PCOS group,and the T of NIR-PCOS group was significantly higher than that of control group,and the LH and T in IR-PCOS group were significantly higher than those in control group,and the difference was statistically significant(P<0.05),while other indicators were not significant(P>0.05).(2)The oocyte maturation rates of the control group,IR-PCOS group,and NIR-PCOS group were88.51±11.32%,83.00±15.24%,and 88.26±13.16%,respectively.The normal fertilization rates of the three groups were 70.00±20.31%,65.19±19.77%,and 80.80±17.14%,respectively.The D3 high-quality embryo rates of the three groups were 47.08±20.81%,30.11±14.16%,and 43.22±18.40%,respectively.The available blastocyst formation rates of the three groups were 64.33±22.35%,46.14±17.69%,and 54.94±18.96%,respectively.The oocyte maturation rates of the three groups were not significantly different.However,the D3 high-quality embryo rates and available blastocyst formation rates of the IR-PCOS group were significantly lower than those of the control group and NIR-PCOS group(P<0.05),with statistical significance.(3)The concentrations of AMH(ng/m L),BMP15(pg/m L),and TNF-α(pg/m L)in the follicular fluid of the control group,IR-PCOS group,and NIR-PCOS group were 3.45±0.97,4.69±1.31,and 4.84±1.26 for AMH;20.84±6.23,16.89±3.99,and 16.72±5.19 for BMP15;and 5.21±2.40,7.35±2.02,and 5.98±2.26 for TNF-α,respectively.Upon comparison,the expression levels of AMH and TNF-α in the IR-PCOS group were significantly higher than those in the control group(P<0.001),and the expression level of TNF-α was also significantly higher than that in the NIR-PCOS group(P<0.001).However,the expression level of BMP15 was significantly lower than that in the control group(P<0.01).These differences were statistically significant.(4)The AMH concentration in the follicular fluid of PCOS patients was significantly positively correlated with oocyte maturation rate,normal fertilization rate,and D3 high-quality embryo rate(r=0.428,r=0.586,and r=0.322,respectively).There was no significant correlation with usable blastocyst formation rate(P>0.05).The BMP15 concentration was significantly positively correlated with usable blastocyst formation rate(r=0.393)and weakly positively correlated with D3high-quality embryo rate(r=0.268).However,there was no significant correlation with oocyte maturation rate and normal fertilization rate(P>0.05).TNF-α was significantly negatively correlated with normal fertilization rate,D3 high-quality embryo rate,and usable blastocyst formation rate(r=-0.328,r=-0.725,and r=-0.450,respectively),but there was no significant correlation with oocyte maturation rate(P>0.05).(5)The concentrations of AMH(ng/m L),BMP15(pg/m L),and TNF-α(pg/m L)in the follicular fluid of the PCOS pregnancy group and non-pregnancy group were 5.35±1.44 and4.33±0.94 for AMH,19.09±5.08 and 15.07±3.35 for BMP15,and 5.63±2.26 and7.41±1.92 for TNF-α,respectively.Upon comparison,the levels of AMH and BMP15 in the follicular fluid of the PCOS pregnancy group were significantly higher than those in the non-pregnancy group,with statistically significant differences(P<0.01).The level of TNF-α in the PCOS pregnancy group was significantly lower than that in the non-pregnancy group,with statistically significant differences(P<0.01).Conclusion(1)Combined detection of AMH,BMP15,and TNF-α levels in the follicular fluid of PCOS patients have predictive value for the clinical pregnancy outcome of IVF.(2)IR can aggravate the poor development of embryos in PCOS infertile patients and IR should be evaluated in time for PCOS infertile patients.