ANTIMüLLERIAN HORMONE IN FOLLICULAR FLUID OF NORMOGONADOTROPHIC WOMEN UNDERTAKING IVF/ICSI cycles: a candidate biomarker of oocyte quality and embryo implantation potential

OBJECTIVE: To investigate the impact of follicular fluid (FF) proteomic composition vs AMH levels as biomarkers of oocyte quality and embryo implantation potential. DESIGN: 270 patients included into a two-arms randomized open-lable prospective study. A fixed antagonist protocol + ar-FSH stimulation was used. r-hCG was used to trigger ovulation. MATERIALS ANDMETHODS: Inclusion criteria: FSH d3%10 IU/mL, BMI >20 and < 27 kg/m2, Age <38. Exclusion criteria: PCOS, endometriosis, endocrine, genetic, systemic inflammatory-immunological disorders. 135 patients with N 3 Follicles with FF AMH level R4,0 ng/ml. 135 patients with N 3 Follicles with FFAMH level%1,0 ng/ml. Proteomic analyses were carried out by 2D isoelectric focusing by the direct sample rehydratation method followed by Sypro Ruby staining and comparison with PDQuest software. Non parametric comparison, c, Mann-Whitney test were used. Logistic regression was used to calculate the likelihood of live birth in relation to the protein spot of interest. RESULTS: 15 potential FF protein were identified: aHaptoglobin, mitochondrial integrity genome, apolipoprotein H, transferrin, lyzozymeC,afibrinogen,immunoglobulin heavy chain V-III were increased in the live birth group,whereas gand b chains fibrinogen, antithrombin, vitamin D-binding protein, and complement 3 and 4 were decreased. Serological and FF AMH levels influence FF soluble proteome. In the high FF AMH levels 84% were down-regulated (transferrin, immunoglobulin light chain, albumin,CO4 complement) and 16% up-regulated (immunoglobulin unknown chain, clusterin,a-1-antitrypsin,a-2-HS-glycoprotein,antithrombin,b-fibrinogen,apolipoprotein A2.Haptoglobin was either downor up-regulated. CONCLUSION: 2D protein mapping allowed identification of several proteins that may play a role in follicle physiology and ovarian activity. Proteomic evaluation of follicular fluid is able to identify potential biomarkers of good versus poor prognosys patients. AMH levels influence oocyte quality and embryo implantation potential.