Mitochondrial energy metabolism is downregulated in repeated implantation failure patients related to alteration of PGC‐1α acetylation level

Herein we aimed at exploring mitochondrial energy metabolism status in patients with repeated implantation failure (RIF) and whether key regulatory factor PGC‐1α of energy metabolism is involved in the decidualization of endometrial stromal cells. Mitochondrial oxidative phosphorylation level and ATP synthesis were compared in primary endometrial stromal cells from RIF and control group. At the same time, as one of key transcription regulators of mitochondrial energy metabolism, the expression level and acetylation level of PGC‐1α were compared with two groups. Then, we downregulated the acetylation levels of PGC‐1α, and the expression of decidual markers (PRL and IGFBP1) was observed further. Mitochondrial energy metabolism, showing by mitochondrial oxidative phosphorylation level and ATP synthesis, was decreased in the endometrial stromal cells of the RIF group (RIF‐hEnSCs). Meanwhile, PGC‐1α acetylation levels were significantly higher in RIF‐hEnSCs. When we reduced the acetylation levels of PGC‐1α in RIF‐hEnSCs, the basal O2 consumption rate and maximal respiration were increased, and also the PRL and IGFBP1. Overall, our data indicated that the endometrial stromal cells of the RIF patients had low level of mitochondrial energy metabolism. Reducing acetylation level of key energy metabolism regulator PGC‐1α can increase the decidualization level of RIF‐hEnSCs. These findings may inspire new ideas about the treatment of RIF.