■本研究旨在分析生殖道微生态变化之间的关系,代谢差异,和妊娠结局在冻融胚胎移植周期的不同时间点,而患者正在接受激素替代治疗,这将是改善结果的突破口。
■本研究招募了2022年7月至2023年1月在福建省妇幼保健院生殖医学中心首次接受冻融单囊胚移植的20名女性。在月经2-5天收集其阴道和宫颈分泌物进行16SrRNA测序和非靶向代谢组学分析,雌激素替代疗法开始后第7天,添加黄体酮的那一天,和移植的日子。根据受试者的临床妊娠情况将其分为不同的组,并采用生物信息学方法对测序结果进行分析。
■1)月经第2-5天阴道和宫颈微生物群的α多样性指数较高(P<0.01),但在口服雌激素替代疗法开始后第7天没有显着差异,黄体酮给药的那一天,和移植日(P≥0.1)。2)妊娠组和非妊娠组在不同时间点下生殖道均表现出多种微生物和代谢产物差异显著。3)不同时间点的微生物分析显示阴道菌群存在显著差异,包括Peptoniphilus,Enterocloster,Finegoldia,克雷伯菌属,厌氧丁酸,Agathobaculum,孢子菌,双亲,普雷沃氏菌,妊娠组无球菌血症(P<0.05)。4)不同时间点的代谢物分析表明,3-羟基苯甲酸存在显著差异,linatine,(R)-苯丙胺,羟氯喹,妊娠组阴道分泌物中L-altarate(P<0.05),异柠檬酸存在显著差异,quassin,citrinin,宫颈分泌物中12(R)-HETE(P<0.05)。5)不同时间点的代谢物分析表明,在非怀孕组中,利那汀有显著差异,癸酰-L-肉碱,阿斯巴甜,鞘氨醇,阴道分泌物中的羟氯喹(P<0.05),和异柠檬酸,quassin,ctrinin,宫颈分泌物中12(R)-HETE(P<0.05)。6)微生物组和代谢组学联合分析表明,某些代谢产物与微生物群落显著相关,尤其是克雷伯菌.
■在激素替代疗法的冷冻胚胎移植周期中,发现不同时间点的微生物区属和代谢物存在显着差异,它可以作为预测胚胎移植妊娠结局的潜在生物标志物。
UNASSIGNED: This study aims to analyze the relationship between reproductive tract microecological changes, metabolic differences, and pregnancy outcomes at different time points in the frozen-thawed embryo transfer cycle while patients are undergoing hormone replacement therapy, which will be a breakthrough point for improving outcomes.
UNASSIGNED: A total of 20 women undergoing frozen-thawed single blastocyst transfer for the first time at the Reproductive Medicine Center of Fujian Maternal and Child Health Hospital between July 2022 and January 2023 were recruited for this study. Their vaginal and cervical secretions were collected for 16S rRNA sequencing and non-targeted metabolomics analysis on days 2-5 of menstruation, day 7 after estrogen replacement therapy started, the day when progesterone was added, and the day of transplantation. The subjects were divided into different groups according to their clinical pregnancy status and the sequencing results were analyzed using bioinformatics methods.
UNASSIGNED: 1) The alpha-diversity index of the vaginal and cervical microbiota was higher on days 2-5 of menstruation (P<0.01), but did not differ significantly on day 7 after oral estrogen replacement therapy started, the day of progesterone administration, and the day of transplantation (P≥0.1). 2) Both the pregnant group and the non-pregnant group showed a variety of microorganisms and metabolites with significant differences in the lower reproductive tract at different time points. 3) Microbial analysis at different time points showed that there were significant differences in vaginal flora, including Peptoniphilus, Enterocloster, Finegoldia, Klebsiella, Anaerobutyricum, Agathobaculum, Sporanaerobacter, Bilophila, Prevotella, and Anaerococcus in the pregnant group (P<0.05). 4) Metabolite analysis at different time points showed that there were significant differences in 3-hydroxybenzoic acid, linatine, (R)-amphetamine, hydroxychloroquine, and L-altarate in the vaginal secretions of the pregnant group (P<0.05), and that there were significant differences in isocitric acid, quassin, citrinin, and 12(R)-HETE in the cervical secretions (P<0.05). 5) Metabolite analysis at different time points showed that, in the non-pregnant group, there were significant differences in linatine, decanoyl-L-carnitine, aspartame, sphingosine, and hydroxychloroquine in the vaginal secretions (P<0.05), and the isocitric acid, quassin, ctrinin, and 12(R)-HETE in the cervical secretions (P<0.05). 6) Combined microbiome and metabolomics analysis showed that certain metabolites were significantly associated with microbial communities, especially Klebsiella.
UNASSIGNED: Significant differences in the microbiota genera and metabolites at different time points were found during the frozen-embryo transfer cycle of hormone replacement therapy, which may be used as potential biomarkers to predict pregnancy outcomes of embryo transfer.