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    High-resolution 1H-NMR spectroscopy indicates variations in metabolomics profile of follicular fluid from women with advanced maternal age
    (Springer/Plenum Publishers, 2020) Dogan, B.; Karaer, A.; Tuncay, G.; Tecellioglu, N.; Mumcu, A.
    Aim To reveal whether there are differences in follicular fluid metabolomics profile of women with advanced maternal age (AMA). Method The group with advanced maternal age includes 23 patients above the age of 40, and the control group includes 31 patients aged between 25 and 35 years and AMH values above 1.1 ng/mL with no low ovarian response history. A single follicular fluid sample from a MII oocyte obtained during the oocyte pick-up procedure was analyzed with high-resolution H-1-NMR (nuclear magnetic resonance) spectroscopy. The results were evaluated using advanced bioinformatics analysis methods. Results Statistical analysis of the NMR spectroscopy data from two groups showed that alpha-glucose and beta-glucose levels of follicular fluid were decreased in the patients with AMA, while in contrast, lactate and trimethylamine N-oxide (TMAO) levels were increased in these patients compared with the controls. In addition to these, there was an increase in alanine levels and a decrease in acetoacetate levels in patients with AMA. However, these changes were not statistically significant. Conclusion Obtained results suggest that the follicular cell metabolism of patients with AMA is different from controls. These environmental changes could be associated with the low success rates of IVF treatment seen in these patients.
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    The vaginal microbiota composition of women undergoing assisted reproduction: a prospective cohort study
    (Wiley, 2021) Karaer, A.; Dogan, B.; Gunal, S.; Tuncay, G.; Duz, S. Arda; Unver, T.; Tecellioglu, N.
    Objective To evaluate the impact of vaginal microbiota on pregnancy outcomes in women undergoing assisted reproduction. Design A prospective cohort study. Setting A university-based assisted reproductive technology (ART) centre. Population 223 women undergoing ART treatment. Methods Prior to embryo transfer, vaginal samples were collected from the posterior fornix. Vaginal microbiota identification was carried out using next-generation sequencing and categorised according to the V3-V4 hypervariable region in the 16S rRNA gene region. Main outcome measures ART clinical outcomes (implantation, clinical pregnancy rates and live birth rates). Results The live birth rate in women with community state type (CST)-I (39%) was higher than that in women with CST-III (21.5%) but the difference was not statistically significant (P = 0.052). The relative abundance of Lactobacillus was lower in women who failed to become pregnant (NP group) (67.71%) than in women who became pregnant (PR group) (79.72%). However, this difference was not statistically significant (P = 0.06). In the NP group, the relative abundance of Streptococcus (7.81%) and Gardnerella (9.40%) was higher than that in the PR group (relative abundance of Streptococcus and Gardnerella was 2.28% and 5.56%, respectively). The abundance of Streptococcus was found to be statistically significantly different between the two study groups (P = 0.014). Linear discriminant analysis (LDA) further validated that Streptococcus had the highest contribution (LDA score >4.0) to the difference between these two groups. Conclusions Streptococcus has the highest contribution to the distinction between the PR and NP groups. Tweetable abstract A relatively high abundance of Streptococcus in the vaginal microbiota may be associated with a lower ART success rate.