title: Women with reduced ovarian reserve or advanced maternal age have an altered follicular environment.
abstract: OBJECTIVE
  To determine whether altered follicular environment is associated with ovarian reserve or maternal age.
  
  
  METHODS
  Prospective study examining follicular fluid (FF) composition and follicular cell metabolism.
  
  
  METHODS
  University research department and private IVF clinic.
  
  
  METHODS
  Women (n = 54) undergoing routine IVF treatment were allocated to one of three groups based on ovarian reserve and maternal age.
  
  
  METHODS
  Surplus FF, granulosa cells (GC), and cumulus cells (CC) were collected.
  
  
  METHODS
  Follicular fluid concentrations of carbohydrates, hormones, and selected ions. Metabolic analysis and gene expression of GCs and CCs.
  
  
  RESULTS
  Compared to women <35 years with normal ovarian reserve, FF glucose levels were significantly decreased and lactate and progesterone (P4) concentrations significantly increased in women with reduced ovarian reserve or advanced maternal age, whereas GC and CC glucose uptake, lactate production, and phosphofructokinase platelet gene expression were significantly increased. Granulosa cell P4 production from women with reduced ovarian reserve or advanced maternal age was decreased; however, in CCs the reverse was observed with increased gene expression in P4 receptor, prostaglandin E receptor-2, cytosolic phospholipase A2, and tumor protein 53.
  
  
  CONCLUSIONS
  Women with either reduced ovarian reserve or advanced maternal age have altered follicular cell metabolism, FF metabolites, and P4 production. This perturbed environment may be responsible for impaired oocyte developmental competence and subsequent embryo development.
authors: School of Pediatrics and Reproductive Health, Robinson Institute, University of Adelaide, Adelaide, South Australia, Australia.
authors: Leanne
authors: L
authors: Pacella
authors: Deirdre L
authors: DL
authors: Zander-Fox
authors: David T
authors: DT
authors: Armstrong
authors: Michelle
authors: M
authors: Lane
mesh_terms: D000328:Adult; D000418:Albumins / Q000378:metabolism; D050260:Carbohydrate Metabolism / Q000502:physiology; D002478:Cells, Cultured; D054885:Cumulus Cells / Q000166:cytology / Q000378:metabolism; D004958:Estradiol / Q000378:metabolism; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000378:metabolism*; D005947:Glucose / Q000378:metabolism; D006019:Glycolysis / Q000502:physiology; D006107:Granulosa Cells / Q000166:cytology / Q000378:metabolism; D006801:Humans; D007247:Infertility, Female / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D008423:Maternal Age; D054315:Oocyte Retrieval / Q000379:methods; D009865:Oocytes / Q000166:cytology / Q000378:metabolism*; D006080:Ovarian Follicle / Q000166:cytology / Q000378:metabolism*; D010740:Phospholipases / Q000378:metabolism; D011374:Progesterone / Q000378:metabolism; D011446:Prospective Studies; D011453:Prostaglandins / Q000378:metabolism
chemical_list: D000418:Albumins; D011453:Prostaglandins; D011374:Progesterone; D004958:Estradiol; D010740:Phospholipases; D005947:Glucose