TY - JOUR
T1 - Identification of common genetic polymorphisms associated with down-regulated gonadotropin levels in an exome-wide association study
AU - Shi, Yue
AU - Miao, Ben yu
AU - Ai, Xi xiong
AU - Cao, Ping
AU - Gao, Jun
AU - Xu, Yan
AU - Yang, Qun
AU - Fei, Jia
AU - Zhang, Qian
AU - Mai, Qing yun
AU - Wen, Yang xing
AU - Qu, Yan lin
AU - Zhou, Can quan
AU - Xu, Yan wen
N1 - Funding Information:
Supported by the National Natural Science Foundation of China (81771588), the National Key Research and Development Program (2018YFC1003102), the Guangzhou Science and Technology Project (201804020087), and the Stem Cell Research Founding of Chinese Medical Association (19020010780).
Publisher Copyright:
© 2023 American Society for Reproductive Medicine
PY - 2023/9
Y1 - 2023/9
N2 - Objective: To investigate whether common genetic polymorphisms are associated with gonadotropin levels after down-regulation with daily gonadotropin-releasing hormone agonist and whether the polymorphisms of candidate variants influence the ovarian response to exogenous gonadotropins. Design: Genetic association study. Setting: University-affiliated in vitro fertilization center. Patients: Subjects enrolled in an exploratory exome-wide association study (n = 862), a replication exome-wide association study (n = 86), and a classifier validation study (n = 148) were recruited from September 2016 to October 2018, September 2019 to September 2020, and January 2021 to December 2021, respectively. The included patients were aged =40 years and had a basal follicle-stimulating hormone (FSH) =12 IU/L. Interventions: All participants received a luteal phase down-regulation long protocol. Genome DNA was extracted from the peripheral blood leukocytes. For the exploratory and replication cohorts, exome sequencing was conducted on a HiSeq 2500 sequencing platform. The multiplex polymerase chain reaction amplification technique and next-generation sequencing also were performed in the exploratory and replication cohorts. For the samples of the validation cohort, Sanger sequencing was performed. Main Outcome Measures: The primary endpoint was the gonadotropin levels after down-regulation, and the secondary endpoints were hormone levels and follicle diameters during stimulation, the total dose of FSH, duration of FSH stimulation, number of oocytes retrieved, and clinical pregnancy rate. Results: In the exploratory cohort, we identified that FSHB rs6169 (P=2.71 × 10-24) and its single-nucleotide polymorphisms in high linkage disequilibrium were associated with the down-regulated FSH level. The same locus was confirmed in the replication cohort. Women carrying the C allele of FSHB rs6169 exhibited higher average estradiol level during stimulation (P=6.82 × 10-5), shorter duration of stimulation, and less amount of exogenous FSH (Pduration=0.0002; Pdose=0.0024). In the independent validation set, adding rs6169 genotypes into the prediction model for FSH level after down-regulation enhanced the area under the curve from 0.560 to 0.712 in a logistic regression model, and increased prediction accuracy by 41.05% when a support vector machine classifier was applied. Conclusion: The C allele of FSHB rs6169 is a susceptibility site for the relatively high level of FSH after down-regulation, which may be associated with increased ovarian FSH sensitivity.
AB - Objective: To investigate whether common genetic polymorphisms are associated with gonadotropin levels after down-regulation with daily gonadotropin-releasing hormone agonist and whether the polymorphisms of candidate variants influence the ovarian response to exogenous gonadotropins. Design: Genetic association study. Setting: University-affiliated in vitro fertilization center. Patients: Subjects enrolled in an exploratory exome-wide association study (n = 862), a replication exome-wide association study (n = 86), and a classifier validation study (n = 148) were recruited from September 2016 to October 2018, September 2019 to September 2020, and January 2021 to December 2021, respectively. The included patients were aged =40 years and had a basal follicle-stimulating hormone (FSH) =12 IU/L. Interventions: All participants received a luteal phase down-regulation long protocol. Genome DNA was extracted from the peripheral blood leukocytes. For the exploratory and replication cohorts, exome sequencing was conducted on a HiSeq 2500 sequencing platform. The multiplex polymerase chain reaction amplification technique and next-generation sequencing also were performed in the exploratory and replication cohorts. For the samples of the validation cohort, Sanger sequencing was performed. Main Outcome Measures: The primary endpoint was the gonadotropin levels after down-regulation, and the secondary endpoints were hormone levels and follicle diameters during stimulation, the total dose of FSH, duration of FSH stimulation, number of oocytes retrieved, and clinical pregnancy rate. Results: In the exploratory cohort, we identified that FSHB rs6169 (P=2.71 × 10-24) and its single-nucleotide polymorphisms in high linkage disequilibrium were associated with the down-regulated FSH level. The same locus was confirmed in the replication cohort. Women carrying the C allele of FSHB rs6169 exhibited higher average estradiol level during stimulation (P=6.82 × 10-5), shorter duration of stimulation, and less amount of exogenous FSH (Pduration=0.0002; Pdose=0.0024). In the independent validation set, adding rs6169 genotypes into the prediction model for FSH level after down-regulation enhanced the area under the curve from 0.560 to 0.712 in a logistic regression model, and increased prediction accuracy by 41.05% when a support vector machine classifier was applied. Conclusion: The C allele of FSHB rs6169 is a susceptibility site for the relatively high level of FSH after down-regulation, which may be associated with increased ovarian FSH sensitivity.
KW - association analysis
KW - controlled ovulation stimulation
KW - Gene polymorphism
KW - pituitary down-regulation
KW - whole exome sequencing
U2 - 10.1016/j.fertnstert.2023.03.031
DO - 10.1016/j.fertnstert.2023.03.031
M3 - Article
C2 - 37001689
SN - 0015-0282
VL - 120
SP - 671
EP - 681
JO - Fertility and Sterility
JF - Fertility and Sterility
IS - 3
ER -