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. 2020 Sep;8(17):1049.
doi: 10.21037/atm-20-397.

Peroxiredoxin 4, a new oxidative stress marker in follicular fluid, may predict in vitro fertilization and embryo transfer outcomes

Qian Yi  1 , Chao Meng  2 , Ling-Bo Cai  1 , Yu-Gui Cui  1 , Jia-Yin Liu  1 , Yan Meng  1
Affiliations

Peroxiredoxin 4, a new oxidative stress marker in follicular fluid, may predict in vitro fertilization and embryo transfer outcomes

Qian Yi et al. Ann Transl Med. 2020 Sep.

Abstract

Background: Peroxiredoxin 4 (Prdx4), a member of the Prdx family, can catalyze the reduction of reactive oxygen species. This study aims to explore whether Prdx4 can serve as an effective marker in follicular fluid (FF) for predicting in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycle outcomes.

Methods: In this prospective study, all participants were recruited from the center of clinical reproductive medicine from 2017 September to 2018 December. Women with tubal or male factor infertility undergoing their first IVF/ICSI cycle were recruited (n=138). FF samples from each patient were collected on the day of oocyte retrieval. Prdx4 concentrations were measured, and the correlation between Prdx4 levels and IVF outcomes was analyzed.

Results: The results showed that pregnant women had higher levels of Prdx4 than nonpregnant women. Prdx4 was positively correlated with the oocyte fertilization rate (r =0.334; P=0.011) and good quality embryo rate (r =0.326; P=0.013). Furthermore, we found that the clinical pregnancy rate was positively correlated with Prdx4 levels in a concentration-dependent manner in the Prdx4 quartiles (<13.38, 13.83-16.93, 16.93-22.93, >22.93 ng/mL). The fertilization rates, clinical pregnancy rates and live pregnancy rates were all significantly higher in the highest Prdx4 quartile group than in the lowest quartile. Moreover, the results indicated that Prdx4 had an area under the receiver operating characteristic curve (AUC) of 0.754, corresponding to an optimal cutoff point of 22.30 ng/mL.

Conclusions: Our results provide evidence that higher expression of antioxidants, such as Prdx4, in the FF of IVF patients tends to indicate a higher likelihood of pregnancy through an oocyte quality mechanism.

Keywords: Follicular fluid (FF); oocyte quality; ovarian stimulation; oxidative stress; peroxiredoxin 4 (Prdx4).

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-20-397). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flow chart of the study. The flow of analyses in this study and how exclusion criteria apply.
Figure 2
Figure 2
The clinical pregnancy rate was positively correlated with Prdx4 levels. All participants were divided into quartiles according to Prdx4 concentrations. The results showed that the clinical pregnancy rates were 6.9%, 27.59%, 41.38% and 62.07% in the four groups, respectively. *, statistically significant (P<0.05); **, highly statistically significant (P<0.01).
Figure 3
Figure 3
ROC curve for the Prdx4 levels in the prediction of clinical pregnancy.
Figure 4
Figure 4
Schematic illustrating the possible roles of Prdx4 in follicular fluid. Upregulated expression of antioxidants, such as Prdx4, in the follicular fluid of IVF patients tends to improve oocyte quality by decreasing oxidative stress.
See this image and copyright information in PMC

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