Association of the renin-angiotensin system components in human follicular fluid with age,ovarian function and IVF laboratory outcomes
Objective To investigate the association between the local renin-angiotensin system(RAS)in human follicular fluid(hFF)and age,ovarian function,in vitro fertilization(IVF)laboratory outcome.Methods A non-intervention observational study was designed.hFF and medical case history without personal identity of patients who received IVF simply because of male factor infertility in Reproductive Medicine Center,the First Affiliated Hospital of Soochow University during January 2021 and February 2022 were collected.The renin,angiotensin converting enzyme(ACE),ACE2,angiotensin(Ang)Ⅱ and Ang 1-7 levels were detected by enzyme-linked immunosorbent assay kit.The correlation between age and RAS in hFF was analyzed by simple linear regression,and multivariate linear regression was used to further analyze the correlation between the RAS and IVF laboratory outcome.Results 1)A total of 139 samples of analysable hFF were obtained.2)There was a linear negative correlation between age and renin(Pearson's r=-0.313 3,P＜0.001),angiotensin converting enzyme(ACE;Pearson's r=-0.183 6,P=0.031),angiotensinⅡ(AngⅡ;Pearson's r=-0.218 6,P=0.010),ACE/ACE2(Pearson's r=-0.319 2,P＜0.001),Ang Ⅱ/Ang1-7(Pearson's r=-0.224 3,P=0.008),while the linear relationship with ACE2 and Ang1-7 was not significant(all P＞0.05).3)Basal follicle-stimulating hormone was positively correlated with age(β= 0.636,P＜0.001),ACE2(β=0.267,P=0.026)and Ang Ⅱ(β=0.268,P=0.001),while negatively correlated with ACE(β=-0.320,P＜0.001)and Ang1-7(β=-0.217,P=0.014).Basal luteinizing hormone was positively correlated with AngⅡ(β=0.330,P=0.003),while negative correlated with Ang1-7(β=-0.395,P=0.002).Antral follicle count was positively correlated with Ang1-7(β=0.153,P= 0.049),while negatively correlated with age(β=-0.869,P＜0.001)and ACE2(β=-0.082,P=0.004).Basal anti-Müllerian hormone was only negatively correlated with age(β=-0.349,P＜0.001).There was no correlation between RAS and basal estradiol,progesterone,prolactin,testosterone(all P＞0.05).4)Oocyte retrieval count was positively correlated with renin(β=0.146,P=0.014),AngⅡ(β= 0.113,P=0.034)and Ang1-7(β=0.185,P=0.002),while negatively correlated with age(β=-0.717,P＜0.001);MⅡ oocyte maturation rate was positively correlated with AngⅡ(β=0.207,P=0.019)and Ang1-7(β=0.217,P=0.026),while negatively correlated with age(β=-0.518,P＜0.001).There was no correlation between RAS and the rates of two pronuclei embryos,transplantable embryos,high-quality embryos(all P＞0.05).Conclusion The local RAS in ovarian follicles is affected by age and correlated with ovarian function and IVF laboratory outcome.
Fertilization in vitroFollicular fluidRenin-angiotensin systemAgeOvary
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