ORIGINAL RESEARCH
Amino acid profile in diminished ovarian reserve
1 Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia
2 Siberian State Medical University, Tomsk, Russia
Correspondence should be addressed: Alla A. Gavisova
Akademika Oparina, 4, Moscow, 117997, Russia; ur.ay@allaivag
Author contribution: Gavisova AA — study design, data acquisition and processing, manuscript writing, editing; Shevtsova MA, Biryukova DA, Lvova PO — study design, data acquisition and processing, literature review, manuscript writing, editing; Novoselova AV, Yushina MN — developing the LC-MS method for analysis of amino acids in blood plasma and follicular fluid, experimental data processing; Ibragimova MH — data acquisition, editing; Chagovets VV, Frankevich VE — statistical data processing, editing.
Compliance with ethical standards: the study was approved by the Ethics Committee of the Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology (protocol № 12 dated 25 November 2021).
Diminished ovarian reserve (DOR) represents a relevant issue of reproductive medicine that is often associated with infertility and reduced efficacy of IVF programs. The changes in amino acid metabolism can play a role in the DOR pathogenesis as manifestations of the folliculogenesis and oogenesis epigenetic alterations. The study was aimed to assess alterations of amino acid metabolic pathways in blood plasma and follicular fluid and estimate their clinical significance in DOR. A total of 115 infertile women aged 25–42 years were included in the study. Groups were formed based on the ovarian reserve and age. Amino acid levels in blood plasma and follicular fluid were assessed by high performance liquid chromatography–mass spectrometry (HPLC-MS); bioinformatics analysis of amino acid metabolic pathways was performed. We revealed significant changes in the phenylalanine, tyrosine and tryptophan biosynthesis (effect = 0.5; p = 0.026), alanine, aspartate and glutamate metabolism (effect = 0.114; p = 0.013), and arginine biosynthesis (effect = 0.289; p < 0.001) pathways playing a role in folliculogenesis, oogenesis, and embryogenesis. The detected differences in the amino acid levels in various body fluids made it possible to construct the logistic regression models confirming DOR with the 88% probability based on the amino acid levels in follicular fluid (sensitivity 88%, specificity 84%) and 82% probability based on plasma levels (sensitivity 65%, specificity 91%). The findings can be used for further research focused on the pathogenesis of infertility associated with DOR and for selection of the most optimal diagnostic and treatment tactics.
Keywords: IVF, diminished ovarian reserve, infertility, amino acid profile, metabolism, metabolic pathway, childbearing age, HPLC-MS