Artificial Reproduction Technology., Dehydroepiandrosterone, DHEAS, Gene Expression of Cumulus Cells., Ovarian Hyper-stimulation Protocol.
Conditions
Keywords
Dehydroepiandrosterone, DHEAS, Gene expression of cumulus cells., Folliculogenesis., Oocyte maturation., Ovarian hyper-stimulation protocol., Artificial reproduction technology.
Brief summary
Diminished ovarian reserve (DOR) is one the challenge in the field of artificial reproductive technology (ART) while there is still no effective resolution of this disorder. In patents with DOR, the pregnancy rate is about only 2-4%. Eventually, patients with DOR turn to adapt children instead. In recent studies, dehydroepiandrosterone (DHEAS) supplement might play a role in reverse diminished ovarian reserve and improve the prognosis of ART. Cumulus cells, formed cumulus-oocyte complex (COC) with oocyte, play a important role in folliculogenesis, oocyte maturation, oocyte meiosis and ovulation. Growing evidences disclose there are crosstalks between oocyte and cumulus cells as paracrine regulations. Aberration the crosswalks between oocytes and cumulus cells would be associated with poor prognosis of folliculogenesis and further pregnancy outcomes. In patients under ovarian hyper-stimulation protocol, the assessment of cumulus cells might be reliable indicators of folliculogenesis, embryo development, pregnancy rate and pregnancy outcomes. These genes (indicators), such as Hyaluronan synthase（HAS2), Versican (VCAN), Thrombospondin 1 (THBS1), Runt-related transcription factor 2 (RUNX2), Chromobox homolog 3 (CBX3),Tripartite motif-containing 28 (TRIM28), B-cell lymphoma 2 (BCL2)，BCL2-associated X protein (BAX). This study was assess the gene expressions of cumulus cells after the DHEAS supplement in patients with DOR under ovarian hyper stimulation protocol.
Detailed description
This study was designed as a prospective case-control study to assess the gene expression of cumulus cells after DHEAS supplement. Patients with diminished ovarian reserve under ovarian hyper-stimulation protocol were evaluated at Kaoshiung Veteran General Hospital from January 1, 2013 through October 31, 2013. Approval for the study was obtained from the hospital's ethic committee, and informed consent was obtained from all patients (VGHKS13-CT11-17)
Interventions
DRUGDehydroepiandrosterone (DHEAS)
Sponsors
National YangMing University
Taipei Veterans General Hospital, Taiwan
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
* DOR: antral follicle count (AFC) less than 5, AntiMullerian hormone (AMH) less than 1.0 ng/ml, and previous total retrieved oocyte less than 5. * Normal Control: antral follicle count (AFC) equal to or more than 5, AntiMullerian hormone (AMH) equal to or more than 1.0 ng/ml, and previous total retrieved oocyte equal to or more than 5. Patient provided signed informed consent.
Exclusion criteria
* Patient who has the allergic history or contraindication to DHEAS usage.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Gene expressions of culumuls cells under ovarian hyper-stimulation protocol. | The 3 or 5 days after oocyte retrieval. | Assessment of gene expressions of cumulus cells, including Hyaluronan synthase (HAS2), Versican (VCAN), Thrombospondin 1(THBS1), Runt-related transcription factor 2 (RUNX2), Chromobox homolog 3 (CBX3), Tripartite motif-containing 28 (TRIM28), B-cell lymphoma 2 (BCL2), BCL2-associated X protein (BAX). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pregnancy outcomes were compared with diminished ovarian reserve and normal control groups after DHEAS supplement. | 2 to 4 weeks after embryo transfer. | The successful pregnancy outcome is defined as intrauterine gestational sac with positive fetal heart activity on the sonogram. |
Countries
Taiwan
Outcome results
None listed