Background: Women with polycystic ovary syndrome (PCOS) have a higher ovarian reserve and 9 number of oocytes retrieved than women with tubal infertility. To assess whether women of 10 advanced age (≥35 years) with PCOS have the same cumulative live birth rate (CLBR) as their age-11 matched controls with tubal factor infertility and to determine the influencing factors on the CLBRs 12 of aged women. 13 Methods: A total of 190 women of advanced age (≥35 years) with PCOS and 627 women with tubal 14 factor infertility were included in our study. All patients underwent their first fresh cycles and 15 subsequent frozen cycles in our centre from 2007 to 2018. To determine independent influencing 16 factors on the CLBRs of these aged patients, a multivariable Cox regression model of CLBR 17 according to the transfer cycle type was constructed. 18 Results: The Cox regression model of the CLBRs indicated that there was no significant difference 19 between the PCOS group and the tubal infertility group in terms of advanced age (HR, 0.96; 95% CI, 20 0.77~1.20). The CLBR significantly decreased for women of advanced reproductive age up to 37 21 years of age (HR, 0.65; 95% CI, 0.53~0.80). The CLBR increased by 31% when more than ten 22 oocytes were retrieved (HR, 1.31; 95% CI, 1.08~1.59). In addition to age and the number of oocytes, 23 the addition of recombinant LH was an independent factor that increased the CLBRs of the women of 24 advanced age (HR, 1.25; 95% CI, 1.03~1.53). 25 Conclusions: Despite the higher number of oocytes retrieved in PCOS patients, the reproductive 26 window is not extended for PCOS patients compared with tubal factor infertility patients. Age, the 27 number of oocytes retrieved and supplementation with LH play crucial roles in the CLBRs of 28 patients of advanced age (≥35 years).
Objective High expression of VEGF in ovarian tissue, serum and follicular fluid of PCOS women is involved in the physiological and pathogenesis processes of PCOS. Our objective was to investigate the effect of sRAGE on VEGF expression and EGF-like growth factor in PCOS ovarian granulosa cells.Methods We collected ovarian granulosa cells of PCOS patients who underwent in vitro fertilization (IVF). Then treatment ovarian granulosa cells with different concentrations of sRAGE. Levels of VEGF, AREG, BTC and EREG mRNA were examined by quantitative RT-PCR. The protein levels of VEGF, AREG, BTC and EREG were measured by ELISA.Results Treatment with sRAGE decrease the production of VEGF, and the effects were dependent on the concentrations of sRAGE (P < 0.05). Simultaneously, the expression of the EGF-like growth factors AREG, BTC and EREG were decreased, and the expression were dependent on the concentrations of sRAGE (P < 0.05).Conclusions sRAGE may downregulate VEGF expression in PCOS ovarian granulosa cells,and EGF-like growth factor pathway may be involved in this process.
Immunoglobulins are key humoral immune molecules produced and secreted by B lymphocytes at various stages of differentiation. No research has reported whether immunoglobulins are present in the non-proliferative female germ cells—oocytes—and whether they are functionally important for the quality, self-protection, and survival of oocytes. Herein, we found that IgG was present even in the oocytes of immunodeficient mice; the IgG-VDJ regions were highly variable between different oocytes, and H3K27Ac bound and regulated IgG promoter region. Next, IgG mRNA and protein levels increased in response to LPS, and this increment required CR2 on the oocyte membrane. Finally, we revealed three aspects of the functional relevance of oocyte IgG: first, oocytes could upregulate IgG to counteract the increased ROS level induced by CSF1; second, oocytes could upregulate IgG in response to injected virus ssRNA to maintain mitochondria integrity; third, upon bacterial infection, oocytes could secret IgG out to encompass bacteria to survive better than other somatic cells. This study reveals for the first time that the female germ cells, oocytes, can independently adjust intrinsic IgG production to survive in adverse environments.
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