Differential Expression of Transcription Factors OTX2 and SOX15 in Follicular Fluid and Its Impact on Oocyte Maturation in Endometriosis Patients
Differential Expression of Transcription Factors OTX2 and SOX15 in Follicular Fluid and Its Impact on Oocyte Maturation in Endometriosis Patients
Mahdokht Mohammad Esmaeili,1Azam Dalman,2Fatemeh Hassani,3Maryam Shahhoseini,4,*
1. Department of Cell and Molecular Biology Science, Academic Center for Education Culture and Research, Tehran, Iran 2. Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran 3. Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran 4. Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
Introduction: About 10% to 15% of women who are of reproductive age, suffer from endometriosis, a chronic disease marked by the development of endometrial-like tissue outside the uterus. This disease is identified in 30–50% of infertile women and its precise etiology is still unknown. Endometriosis can cause anatomical abnormalities, hormonal imbalances, and inflammatory responses that negatively impact oocyte viability and reproductive outcomes, making the relationship between the condition and infertility complex. Ectopic endometrial tissue can interfere with normal ovarian function and hormone regulation, which can severely compromise oocyte maturation and quality.
Since evaluating oocyte quality directly is challenging, Follicular Fluid (FF) analysis is often employed as an alternative approach. FF is a complex microenvironment that envelops the oocyte and plays a crucial role in its development and quality. Alteration in the environment have been connected to infertility in endometriosis-affected women. Among the mechanisms that affect oocyte maturation and quality in this fluid, we focused on the expression of two specific transcription factors, Orthodenticle Homeobox 2 (OTX2) and SRY-Box Transcription Factor 15 (SOX15), within the FF of women with endometriosis compared to healthy women. The significance of selecting OTX2 and SOX15 in this study is demonstrated by the rise in expression of these two genes during oocyte maturation.
Methods: The mRNA expression levels of OTX2 and SOX15 in the FF of women with endometriosis (n=23) were compared to women without endometriosis as a control group (n=23) in this study using qRT-PCR.
Results: There was no significant difference found between the case and control groups in terms of demographic variables like age, Body Mass Index (BMI), and the levels of Luteinizing Hormone (LH), Follicle-Stimulating Hormone (FSH), and Anti Mullerian Hormone (AMH) that affect oocyte quality. In addition, the statistical analysis of the expression levels of OTX2 and SOX15 did not report a significant difference between the case and control groups, however, a decreasing pattern was seen.
Conclusion: Based on previous studies, OTX2 showed a significant increase in both the endometrium and plasma of patients. SOX15 is also upregulated in the endometrium of the affected individuals. However, there were no significant differences in the expression levels of these genes in the FF of women diagnosed with endometriosis compared to those who are healthy in this study. This implies that OTX2 and SOX15 may influence the pathogenesis of endometriosis through mechanisms other than oocyte maturation. Further research with larger sample sizes and targeted functional analyses is warranted to elucidate the precise mechanisms by which endometriosis may influence the expression of these key transcription factors and their downstream effects on oocyte maturation. Nonetheless, our study underscores the importance of examining the follicular fluid microenvironment in understanding the complex interplay between endometriosis and reproductive health.