Lipid Profiling of Peri-implantation Endometrium in Patients With Premature Progesterone Rise in the Late Follicular Phase
Lipid Profiling of Peri-implantation Endometrium in Patients With Premature Progesterone Rise in the Late Follicular Phase
复制标题
卵泡晚期黄体酮过早升高患者的围着床期子宫内膜的脂质分析。
DOI：
10.1210/jc.2019-00793
复制
发表时间：
2019-11-01
影响因子：
5.8
通讯作者：
Bi, Huichang
中科院分区：
文献类型：
--
作者：
Li, Jingjie;Gao, Yue;Bi, Huichang
上下文
控制性超促排卵（COH）过程中卵泡晚期血清孕酮（P）升高通过促进卵巢-胚胎畸形而对辅助生殖技术（ART）的结局产生负面影响。在此过程中仍然没有关于脂质代谢物改变的数据。
目的
研究孕激素过早升高患者在着床窗口期的血脂变化。
设计
通过超高效液相色谱-电喷雾电离高分辨质谱（UHPLC-ESI-HRMS）评价子宫内膜中的脂质组学变化。
设置
患者或其他参与者：43例因输卵管因素或男性因素不孕而接受IVF/ICSI的患者被纳入本研究。在hCG注射当天将患者分为高孕酮组（P≥ 1.5ng/ml，15例）和正常孕酮组（P<1.5ng/ml，28例）。
干预措施
hCG给药后7天，通过Pipelle活检获得子宫内膜组织。
主要观察指标
脂质代谢物的改变。
结果
共鉴定出1026种离子，25种脂质显著上调。子宫内膜脂质谱的特征是在卵泡期结束时孕酮过早升高的患者中，磷脂酰胆碱（PC）、磷脂酰乙醇胺（PE）、溶血磷脂酰胆碱（LPC）、甘油二酯（DG）、神经酰胺（Cer）、磷脂酰肌醇（PI）和磷脂酰丝氨酸（PS）的浓度显著增加。孕酮水平与血脂的相关分析显示，PE或PS与孕酮水平呈较强的负相关。
结论
孕激素过早升高破坏了围着床期子宫内膜的脂质平衡。脂质水平的改变可能损害子宫内膜容受性和早期胚胎着床。
CONTEXT
Late follicular phase elevation in serum progesterone (P) during controlled ovarian hyperstimulation (COH) negatively affects the outcome of assisted reproductive technology (ART) by contributing to endometrial-embryo asynchrony. There are still no data on lipid metabolite alterations during this process.
OBJECTIVE
To investigate alterations in the lipid profile during the window of implantation in patients with premature progesterone rise.
DESIGN
Lipidomic variations in the endometrium were evaluated by ultrahigh-performance liquid chromatography coupled with electrospray ionization high-resolution mass spectrometry (UHPLC-ESI-HRMS).
SETTING
University assisted reproductive medicine unit.Patients or Other Participants: Forty-three patients undergoing IVF/ICSI due to tubal factor or male factor infertility were included in this study. The patients were divided into a high progesterone group (P≥1.5 ng/ml, 15 patients) and a normal progesterone group (P<1.5 ng/ml, 28 patients) on the day of hCG administration.
INTERVENTIONS
The endometrial tissues were obtained by Pipelle biopsy 7 days after hCG administration.
MAIN OUTCOME MEASURES
Alterations in lipid metabolites.
RESULTS
A total of 1026 ions were identified, and 25 lipids were significantly upregulated. The endometrial lipid profile was characterized by significant increases in the concentrations of phosphatidylcholine (PC), phosphatidylethanolamine (PE), lysophosphatidylcholine (LPC), diacylglycerol (DG), ceramide (Cer), phosphatidylinositol (PI), and phosphatidylserine (PS) in patients with a premature progesterone rise at the end of the follicular phase. The correlation analysis between progesterone levels and lipids showed a stronger negative correlation between PE or PS and progesterone levels.
CONCLUSIONS
Premature progesterone elevation disrupts the lipid homeostasis of the endometrium during the peri-implantation period. The altered lipid levels may impair endometrial receptivity and early embryo implantation.