Study On Predicting Ovarian Reserve Function Of Follicular Fluid Putrescine

Purpose:To study the relationship between the content of putrescine in follicular fluid and ovarian reserve and oxidative stress in follicular fluid.To explore whether putrescine affects ovarian reserve function through oxidative stress pathway,and also to promote egg maturation in vitro by adding putrescine to immature oocyte culture medium of elderly women with decreased ovarian reserve function,so as to provide new research ideas for improving ovarian reserve function and egg quality in elderly patients.Methods:From June 2019 to January 2020,160 infertile women(20-45 years old)were selected for IVF embryo transfer or intracytoplasmic sperm injection in reproductive medicine center of Jiangsu Provincial People’s Hospital.According to the patient’s ovarian stimulation regimen,it was divided into three study groups,which were 65 in the long regimen group,53 in the antagonist regimen group and 42 in the microstimulus regimen group.According to the age of women,the patients under the same ovarian stimulation program were divided into two groups,namely,35-48 years old group and 20-34 years old group,and compared the content of follicular fluid putrescine in different age groups under the same ovulation promotion program.At the same time,the content of the oxidative stress substance malondialdehyde and the total antioxidant capacity in follicular fluid were determined.At the same time,the basic information of patients such as age,AFC、AMH and embryo laboratory data were collected to analyze whether the difference of putrescine content was related to oocyte quality and embryo development potential.Results:The age,total Gn,AMH、AFC and b LH of the two groups were different(P<0.05).The difference between the two groups was age(0.05).(2)The embryo laboratory data of the long-scheme ovulation-promoting group were significantly higher in the young group than in the elderly patients(P<0.05),but there was no significant difference in the number of eggs acquired,the rate PN mature eggs,the number of prokaryotes,the normal fertilization rate,the rate of embryo cleavage and the rate of high quality blastocyst formation between the two groups.the number of eggs acquired,the number of oocytes in the MII stage and the rate of superior embryo in the young group of antagonist ovulation promotion program were significantly higher than those in the elderly group(P<0.05),and there was no significant difference in the laboratory data of the remaining embryo.optimal embryo rate was 66% in the elderly group with micro-stimulated ovulation,significantly lower than in the young group(P=0.014).(3)The levels of putrescine in follicular fluid were lower than those in the young group in the three ovulation-promoting schemes included in the study,but only in the long-term ovulation-promoting group,the levels of putrescine in follicular fluid were 167.18 ng/ml,respectively ng/ml,and 184.70 ng/ml in the young group.(4)The correlation between three groups of embryo laboratory data and putrescine was analyzed.there were significant differences in the correlation coefficients between the two groups of long scheme and micro-stimulation.among them,the micro-stimulation group r=-0.397,and the correlation was the most significant(Pr=0.009).There was a significant positive correlation between the number of transplanted embryos and the number of superior embryos.There was a positive correlation between follicular putrescine and cleavage number,transplantable embryo number and superior embryo number of embryos after fertilization.There was a significant positive correlation between MII oocyte number,2PN prokaryotic number,cleavage number,transplantable embryo number and superior embryo number in the micro-stimulation regimen group.The correlation coefficient between putrescine and superior embryo number r=0.673,and the correlation was close.(5)The TAC content of follicular fluid in the elderly group was higher than that in the young group,and there was significant difference between the MDA and MDA/TAC ratio groups.there was no significant difference in oxidative stress injury markers in follicular fluid between the two groups of antagonist regimen.The correlation between putrescine and MDA 、 TAC and MDA/TAC ratio of three ovulation-promoting schemes was studied,the correlation was not obvious.Conclusions:(1)With the increase of the age of women of childbearing age,the content of putrescine in follicular fluid decreased gradually,showing a significant negative correlation.The content of putrescine in follicular fluid could predict ovarian reserve function to some extent.(2)This study found that the correlation between oxidative stress injury markers and putrescine was not obvious in elderly women with follicular fluid.further study is needed to investigate whether putrescine affects ovarian reserve function through oxidative stress injury pathway.