Kallistatin in follicular fluid of women with endometriosis and its correlation with IVF outcome

Abstract

Background

Endometriosis (EM) affects 10% women of reproductive age and alters fertility. Its management is still debated notably the timing of surgery and ART in infertility. Kallistatin (KS) is an endogenous protein that regulates differential signaling pathways and biological functions. However, the function and the underlying molecular mechanism in EM and its correlation with in vitro fertilization (IVF) outcome have not been determined. The purpose of this study was to evaluate KS concentrations in follicular fluid (FF) of women with EM and controls women without EM who underwent IVF with embryo transfer (IVF–ET).

Methods

FF KS concentrations from 40 patients with EM and 40 non-EM patients were measured by ELISA.

Results

Compared with the non-EM patients, patients with EM had lower KS levels in FF (281.67 ± 104.60 vs. 490.70 ± 216.33 pg/ml). The rates of fertilization (61.64 ± 22.42 vs. 71.00 ± 24.39%), available embryo (45.96 ± 19.83 vs. 50.61 ± 26.26%), and top-quality embryo (12.71 ± 21.01 vs. 16.04 ± 16.87%) were significantly lower in the EM group than in the control group. The KS concentrations in the FF of women who conceived consequent to the treatment were significantly higher than those from women who did not in the combined EM and control groups.

Conclusions

These results indicate that the KS concentration in FF could be used as a predictor for IVF–ET outcomes. This may contribute to the pathologic mechanism responsible for the poor outcome of IVF in patients with EM.

子宫内膜异位症患者卵泡液中的人源性激肽释放酶结合蛋白水平及其与体外受精结局的关系 摘要

背景：子宫内膜异位症（EM）影响10%的育龄妇女并改变其生育能力。它的管理仍然存在争议, 尤其是不孕症的手术和ART的时机。人源性激肽释放酶结合蛋白（KS）是一种内源性蛋白, 调节差异信号通路和生物学功能。然而, EM的功能和潜在的分子机制及其与体外受精（IVF）结局的相关性尚未确定。本研究旨在探讨进行体外受精-胚胎移植 （IVF-ET）的子宫内膜异位症（EM）与非EM患者卵泡液（FF）中KS的浓度。方法：采用酶联免疫吸附试验（ELISA）测定40例EM患者和40例非EM患者血清FF-KS浓度。结果：内异症患者FF中KS水平（281.67±104.60）pg/ml低于非内异症患者（490.70±216.33）pg/ml。EM组受精率（61.64±22.42比71.00±24.39%）、可用胚率（45.96±19.83%比50.61±26.26%）、优质胚率（12.71±21.01%比16.04±16.87%）均显著低于对照组。在联合EM组和对照组中, 在治疗后怀孕的妇女的FF中的KS浓度显著高于那些没有怀孕的妇女。结论：卵泡液中KS浓度可作为IVF-ET结局的预测指标。这可能是导致子宫内膜异位症患者体外受精结局不佳的病理机制之一。

Keywords:

• Endometriosis
• Kallistatin
• follicular fluid
• IVF outcome

Acknowledgments

The study was performed under the auspices of the IVF unit of the Third Affiliated Hospital of Guangzhou Medical University.

Ethical approval and consent to participate

This study was approved by the ethics committee of the Third Affiliated Hospital of Guangzhou Medical University.

Author contributions

All authors have contributed significantly to this manuscript and each author has contributed to the manuscript as follows: Yuling Mao and Rui Chen designed the project. Yuling Mao, Shaoquan Zhan collected clinical samples and performed the ELISA experiments. Jingda Qiao and Lei Li analyzed the data. Yuling Mao wrote the manuscript. Hanyan Liu and Rui Chen revised the manuscript. All authors read and approved the final manuscript.

Disclosure statement

The authors have declared that no conflict of interest exists.

Data availability statement

The data sets used and/or analyzed during this study are available from the corresponding author on reasonable request.

Additional information

Funding

This study was supported by National Nature Science Foundation of China [Grant Number 81871211].