Effect of dehydroepiandrosterone on clinical outcome and GDF-9 and BMP-15 level in follicular fluid of the diminished ovarian reserve women who underwent IVF

doi:10.3969/j.issn.1006-7795.2021.02.004

Abstract

Abstract: Objective To investigate the effects of dehydroepiandrosterone (DHEA) on clinical outcome, the growth differentiation factor-9 (GDF-9), and bone morphogenetic protein-15 (BMP-15) level in follicular fluid of the diminished ovarian reserve (DOR) women who underwent in vitro fertilization embryo transfer/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET).Methods A historical cohort study was performed and the clinical data of 163 DOR women undergoing IVF/ICSI-ET treatment were analyzed. According to pretreatment regiments, the patients were divided into DHEA group and control group. The indexes were compared between two groups, including serum basal hormone levels, anti-Müllerian hormone (AMH), antral follicle counts (AFC), the total doses and duration of gonadotropin (Gn), hormone levels and endometrium thickness on human chorionic gonadotropin (hCG) day, the number of retrieved oocytes, the number of fertilized oocytes, high quality embryo rate, implantation rate, and clinical pregnancy rate. The levels of GDF-9 and BMP-15 in follicular fluid were compared between the two groups, and their correlations with ovarian reserve were analyzed. Results Before pretreatment, there was no significant difference among the two groups in the basal hormone levels, AMH and AFC (P>0.05). Compared with the control group, the AFC of the DHEA group was significantly increased and the basal follicle stimulating hormone (bFSH) was slightly decreased(P<0.05). There was no significant difference between the two groups in the indexes such as the total doses and duration of Gn, hormone levels and endometrium thickness on hCG day, the number of retrieved oocytes, the number of fertilized oocytes , high quality embryo rate, implantation rate, and clinical pregnancy rate (P>0.05). Compared with the control group, the level of BMP-15 in follicular fluid of DHEA group was significantly increased (P<0.05), with no significant difference in GDF-9 (P>0.05). Bilateral Pearson correlation coefficient analysis showed that the expression of BMP-15 in follicular fluid was positively correlated with the basal estradiol (E₂). Conclusion DHEA improved the ovarian reserve of DOR women via increasing AFC and decreasing basal FSH. DHEA also increased the level of BMP-15 in follicular fluid, which was correlated with the basal E₂.

Key words: dehydroepiandrosterone, diminished ovarian reserve, in vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET), growth differentiation factor-9(GDF-9), bone morphogenetic protein-15(BMP-15)

CLC Number:

R711.75

Zhuang Qianying, Wang Qin, Chen Tong, Yang Xiaokui. Effect of dehydroepiandrosterone on clinical outcome and GDF-9 and BMP-15 level in follicular fluid of the diminished ovarian reserve women who underwent IVF[J]. Journal of Capital Medical University, 2021, 42(2): 188-193.

0
/ / Recommend

Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks

URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2021.02.004

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2021/V42/I2/188

References

[1] Pastore L M, Christianson M S, Stelling J, et al.Reproductive ovarian testing and the alphabet soup of diagnoses: DOR, POI, POF, POR, and FOR[J]. J Assist Reprod Genet, 2018, 35(1): 17-23.
[2] Morin S J, Patounakis G,Juneau C R, et al.Diminished ovarian reserve and poor response to stimulation in patients <38 years old: a quantitative but not qualitative reduction in performance[J]. Hum Reprod, 2018, 33(8): 1489-1498.
[3] Ahmad H I, Liu G, Jiang X, et al.Maximum-likelihood approaches reveal signatures of positive selection in BMP15 and GDF9 genes modulating ovarian function in mammalian female fertility[J].Ecol Evolution, 2017, 7(21): 8895-8902.
[4] Wang T T, Ke Z H, Song Y, et al.Identification of a mutation in GDF9 as a novel cause of diminished ovarian reserve in young women[J]. Hum Reprod, 2013, 28(9): 2473-2481.
[5] Steiner A Z, Pritchard D, Stanczyk F Z, et al.Association between biomarkers of ovarian reserve and infertility among older women of reproductive age[J]. JAMA, 2017,318(14): 1367-1376.
[6] Fan Y,Chang Y,Wei L,et al.Apoptosis of mural granulosa cells is increased in women with diminished ovarian reserve[J]. J Assist Reprod Genet, 2019, 36(6): 1225-1235.
[7] 孟靠,马娟,王振.脱氢表雄酮预处理联合生长激素对卵巢储备功能低下IVF-ET患者妊娠结局及卵巢储备功能的影响[J].解放军医药杂志,2020,32(9):93-97.
[8] 杨维,李玛建,何军琴.女禛汤治疗阴虚内热型卵巢储备功能下降临证经验初探[J].首都医科大学学报,2019,40(3):358-362.
[9] Yilmaz N, Uygur D, Inal H, et al.Dehydroepiandrosterone supplementation improves predictive markers for diminished ovarian reserve: serum AMH, inhibin B and antral follicle count[J]. Eur J Obstet Gynecol Reprod Biol, 2013, 169(2): 257-260.
[10] Yeung T W, Chai J, Li R H, et al.A randomized, controlled, pilot trial on the effect of dehydroepiandrosterone on ovarian response markers, ovarian response, and in vitro fertilization outcomes in poor responders[J]. Fertil Steril, 2014,102(1): 108-115.
[11] Cheng X B, Jimenez M, Desai R, et al.Characterizing the neuroendocrine and ovarian defects of androgen receptor knockout female mice[J]. AJP Endocrinol Metab, 2013, 305(6): E717-E726.
[12] Zhang Y, Zhang C, Shu J, et al.Adjuvant treatment strategies in ovarian stimulation for poor responders undergoing IVF: a systematic review and network meta-analysis[J]. Hum Reprod Update, 2020, 26(2): 247-263.
[13] Zangmo R, Singh N, Kumar S, et al.Role of dehydroepiandrosterone in improving oocyte and embryo quality in IVF cycles[J]. Reprod Biomed Online, 2014,28(6): 743-747.
[14] Chang H M, Qiao J, Leung P C.Oocyte-somatic cell interactions in the human ovary-novel role of bone morphogenetic proteins and growth differentiation factors[J]. Hum Reprod Update, 2016,23(1): 11-18.
[15] Shimizu K, Nakamura T, Bayasula, et al. Molecular mechanism of FSHR expression induced by BMP-15 in human granulosa cells[J]. Assist Reprod Genet, 2019,36(6):1185-1194.
[16] Otsuka F, Yao Z, Lee T, et al.Bone morphogenetic protein15. Identification of target cells and biological functions[J]. J Biol Chem, 2000, 275(50): 39523-39528.
[17] Wu Y T, Wang T T, Chen X J, et al.Bone morphogeneticprotein-15 in follicle fluid combined with age may differentiate between successful and unsuccessful poor ovarian responders[J]. Reprod Biol Endocrinol, 2012, 10:116-121.