Irene Woo

Micro-RNAs involved in cellular proliferation have altered expression profiles in granulosa of young women with diminished ovarian reserve

PurposeThe study aims to determine differences in micro-RNA (miRNA) expression in granulosa (GC) and cumulus cells (CC) between young women with diminished ovarian reserve (DOR) or normal ovarian reserve (NOR). Secondary objective was to identify downstream signaling pathways that could ultimately indicate causes of lower developmental competence of oocytes from young women with DOR.MethodsThe method of the study is prospective cohort study.ResultsOf the miRNA, 125 are differentially expressed in GC between DOR and NOR. Only nine miRNA were different in CC; therefore, we focused analysis on GC. In DOR GC, miR-100-5p, miR-16-5p, miR-30a-3p, and miR-193a-3p were significantly downregulated, while miR-155-5p, miR-192-5p, miR-128-3p, miR-486-5p, miR130a-3p, miR-92a-3p, miR-17-3p, miR-221-3p, and miR-175p were increased. This pattern predicted higher cell proliferation in the DOR GC. The primary pathways include MAPK, Wnt, and TGFbeta.ConclusionsThe miRNA pattern identified critical functions in cell proliferation and survival associated with DOR. GC in women with DOR seems to respond differently to the LH surge.

Egg and Embryo Donation

Oocyte donation is designed to overcome blocks to fertility caused by the absence of or deficient function in oocytes. Embryo donation is a practical option for couples with female and male factor infertility who may need both egg and sperm donation. Controlled ovarian stimulation of the oocyte donor is similar to standard IVF. Concerns regarding hyperstimulation can be virtually eliminated with an antagonist protocol with gonadotropin agonist trigger. Preparation of the recipient endometrium and synchronization between donor and recipient are most easily achieved with exogenous estrogen and progesterone. Both donors and recipients should be medically screened and offered psycho-social counseling to address issues of third-party parenting.