Abstract: 【Abstract】 Objective To evaluate the factors on regulating oocyte quality in patients with diminished ovarian reserve (DOR) by analyzing the levels of reactive oxygen species (ROS), melatonin (MLT), growth factor and apoptosis-related factors in follicular fluid. Methods From June to October 2015, 100 in vitro fertilization(IVF) cycles were enrolled in the center of reproductive medicine of Shanghai Changzheng Hospital, Second Military Medical University, which were equally divided into DOR group and normal ovarian reserve (NOR) group. The ovarian reserve function of the patients were estimated on the 2 ～ 3 day of menstrual cycle. The expressions of ROS, MLT, GDF9, BMP15, FAS, BAX and BCL2 were detected in the first tube of large follicular fluid from the cases. The oocyte pick-up in the patients of DOR group was carried out at 36 hours after triggering by routine mild stimulation; in the NOR group, the oocyte pick-up of the cases was carried out at 38 hours after triggering by long-term stimulation. The quality of oocytes was evaluated by the rate of high quality embryo after IVF. The Chi-square test and paired t test were used for statistical analysis. Results The age and the basal level of FSH in DOR group were higher than those in NOR group ［(36.3 ± 4.8 ) vs (30.6 ±4.7) years old, (9.9 ± 3.4) vs (6.8 ± 1.7) IU / L］, The sum of AFC and the number of retrieve follicles each cycle in DOR group were both lower than those in NOR group ［(7.7 ± 4.8) vs (13.8 ± 8.7), (7.5 + 5.1) vs (13.5 + 7.5), respectively］ (P ﹤ 0.01). The rate of high quality embryos in DOR group was lower than that in NOR group (32.4% vs 53.1%, P ﹤ 0.01). There was no significant difference in the level of MLT, BMP15, GDF9, FAS and BAX between DOR group and NOR group (all P ﹥ 0.05).The level of ROS in follicular fluid of DOR group was higher than that of NOR group ［(512±184) vs (345 ± 237) μmol/L］, and the level of BCL2 in the DOR group was lower than that of NOR group ［(382 ±165) vs (654 ±274) ng / L, P ﹤ 0.01). The cases of DOR group were further divided into high ROS group and low ROS group, high BCL2 group and low BCL2 group according to the levels of ROS and BCL2 in follicular fluid. There was no significant differences in the rate of high quality embryo with high ROS and low ROS (24.6% vs 35.1%, P ﹤ 0.01)and the high quality embryo rate of high BCL2 group and low BCL2 group (32.6% vs 32.1%, respectively) (P ﹥ 0.05). Conclusion The levels of ROS and BCL2 in follicular fluid are closely related to the decrease of oocyte quality. The high level of ROS is an important reason to decrease oocyte quality in DOR patients.
王亮 孙宁霞 郝敏 刘延纪 逸萱 李文. 卵泡液中高水平活性氧影响卵巢储备功能低下患者卵母细胞质量[J]. 发育医学电子杂志, 2018, 6(4): 220-224，235.
WANG Liang, SUN Ning-xia, HAO Min, LIU Yan-ji, YI Xuan, LI Wen. High level of reactive oxygen species impacts the quality of oocyte from diminished ovarian reserve patients. Journal of Developmental Medicine(Electronic Version), 2018, 6(4): 220-224，235.
2018, Vol. 6 
