| Objective1.To analyze the possible influencing factors of clinical pregnancy outcome in patients with diminished ovarian reserve during fresh transplantation cycles of IVF-ET.2.To investigate the mitochondrial function of cumulus granulosa cells in patients with diminished ovarian reserve,compared with elderly patients and normal ovarian reserve patients.Methods1.Enroll 251 DOR patients undergoing assisted reproductive technology and transferred in fresh cycle at the Reproductive Medicine Center,the first affiliated hospital of Anhui Medical University from June 2013 to June 2016.A retrospective analysis of clinical outcomes of patients with DOR was performed.The control ovarian stimulation(COS)protocols,patients' age,implantation rates at different developmental stages were compared;2.Thirty patients in the DOR group,30 in the advanced age(>40)group and 30 in the NOR group were collected.Cumulus granulosa cells were mechanically cut from the cumulus complex in ovulation day,and DNA were extracted by DNA isolation kit.Real-time PCR method was used to detect three groups of mitochondrial DNA copy number.Results1.By comparing the results for the same age group but different control ovarian stimulation protocols,and showed that the implantation rate and clinical pregnancy rate with long-protocol were higher than the short-protocol,abortion rate was lower than the short-protocol,but the difference was not statistically significant.(P>0.05)2.By comparing the results for the same COS protocol but different age groups between two age groups(? 35 years old group;<35 years old group),and showed that,Ganodotropin(Gn)dosage total increased with advancedg age,but the clinical results were not statistically different;3.All the enrollers were underwent fresh embryo transfer and divided into two groups(cleavage stage embryos group and blastocyst stage embryos group): No difference in number of embryos transferred,implantation rate,pregnancy rate,abortion rate was observed between the two group;4.The mitochondrial number in DOR group was 0.607±0.298 times as that in NOR group,and the difference was statistically significant(P(27)0.05).The mitochondrial number in the advanced age group was 0.688±0.326 times as that in NOR group,and the difference was statistically significant(P(27)0.05).While there was no statistical different in the number of mitochondria in granulosa cells between the DOR group and the advanced age group.Conclusion1.COS protocols,patients' age affect the clinical outcome of fresh embryo transfer in patients with DOR.We recommend that the patients receive high-quality cleavage embryo transfer in the circumstance of no enough number of oocytes;2.The relative reduction of mitochondria in cumulus granulosa cells may be the important cause of egg quality decline in DOR patients. |
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