Earlier Oocyte Retrieval May Aid Older Women Undergoing IVF
(HealthDay News) — Earlier oocyte retrieval can help avoid premature follicular luteinization in older women undergoing in vitro fertilization (IVF), according to a study published online Aug. 11 in the Journal of Endocrinology.
Yan-Guang Wu, Ph.D., from the Center for Human Reproduction in New York City, and colleagues compared granulosa cell (GC) function in young oocyte donors (ages 21 to 29; 31 women) and in middle-aged (aged 30 to 37; 64 women) and older (aged 43 to 47; 41 women) infertile patients.
The researchers found that with advancing age there was downregulation in follicle-stimulating hormone (FSH) receptor, aromatase, and 17β-hydroxysteroid dehydrogenase expression, while upregulation was seen in luteinizing hormone receptor, P450scc, and progesterone receptor. With aging, GCs exhibited lower proliferation and increased apoptosis upon in vitro culture. In vitro, FSH supplementation stimulated GCs growth and prevented luteinization. In women above age 43, human chorionic gonadotropin was administered to advance oocyte retrieval at maximal leading follicle size of 16 mm to avoid premature luteinization. Patients with earlier retrieval demonstrated only a marginal increase in oocyte prematurity compared to normal cycles in women of similar age, but exhibited improved embryo numbers and quality, as well as 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," the authors write.
Several authors disclosed financial ties to Fertility Nutraceuticals.