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Aging-related premature luteinization of granulosa cells is avoided by early oocyte retrieval
- Source :
- The Journal of endocrinology. 226(3)
- Publication Year :
- 2015
-
Abstract
- Why IVF pregnancy rates decline sharply after age 43 is unknown. In this study, we compared granulosa cell (GC) function in young oocyte donors (n=31, ages 21–29), middle-aged (n=64, ages 30–37) and older infertile patients (n=41, ages 43–47). Gene expressions related to gonadotropin activity, steroidogenesis, apoptosis and luteinization were examined by real-time PCR and western blot in GCs collected from follicular fluid. FSH receptor (FSHR), aromatase (CYP19A1) and 17β-hydroxysteroid dehydrogenase (HSD17B) expression were found down regulated with advancing age, while LH receptor (LHCGR), P450scc (CYP11A1) and progesterone receptor (PGR) were up regulated. Uponin vitroculture, GCs were found to exhibit lower proliferation and increased apoptosis with aging. While FSH supplementation stimulated GCs growth and prevented luteinizationin vitro. These observations demonstrate age-related functional declines in GCs, consistent with premature luteinization. To avoid premature luteinization in women above age 43, we advanced oocyte retrieval by administering human chorionic gonadotropin at maximal leading follicle size of 16 mm (routine 19–21 mm). Compared to normal cycles in women of similar age, earlier retrieved patients demonstrated only a marginal increase in oocyte prematurity, yet exhibited improved embryo numbers as well as quality and respectable clinical pregnancy rates. Premature follicular luteinization appears to contribute to rapidly declining IVF pregnancy chances after age 43, and can be avoided by earlier oocyte retrieval.
- Subjects :
- Adult
endocrine system
medicine.medical_specialty
Aging
17-Hydroxysteroid Dehydrogenases
medicine.drug_class
Endocrinology, Diabetes and Metabolism
Granulosa cell
medicine.medical_treatment
Down-Regulation
Oocyte Retrieval
Biology
Human chorionic gonadotropin
Andrology
Young Adult
Endocrinology
Aromatase
Pregnancy
Internal medicine
Follicular phase
medicine
Humans
In vitro fertilisation
Granulosa Cells
Age Factors
Middle Aged
Receptors, LH
Oocyte
Follicular fluid
Up-Regulation
Luteinization
medicine.anatomical_structure
Gene Expression Regulation
Receptors, FSH
Female
Gonadotropin
Follicle-stimulating hormone receptor
Receptors, Progesterone
Subjects
Details
- ISSN :
- 14796805
- Volume :
- 226
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- The Journal of endocrinology
- Accession number :
- edsair.doi.dedup.....cd0ca8bd732bb85884f53931b4b3420b