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Cholesterol metabolism is decreased in patients with diminished ovarian reserve

Published:September 23, 2021DOI:https://doi.org/10.1016/j.rbmo.2021.09.013

      Abstract

      Research question

      Does cholesterol metabolism differ in patients with diminished ovarian reserve (DOR) compared to patients with normal ovarian reserve (NOR)?

      Design

      The current research included 72 women with NOR and 86 women with DOR. Data on the cholesterol metabolism in granulosa cells of these women were analysed.

      Results

      On the day of human chorionic gonadotrophin injection, serum oestradiol and progesterone in the DOR group were significantly lower than in the control group (P < 0.001). There were no significant differences in serum concentrations of total cholesterol, triglyceride, high-density lipoprotein and low-density lipoprotein between the NOR and DOR groups. The cholesterol-regulated gene SCAP in granulosa cells from women with DOR was down-regulated (P = 0.024). Cholesterol synthesis and transport genes (e.g. IDI1, FDFT1, CYP51A1, SRB1 and STARD1) were also significantly decreased (P = 0.026, P = 0.044, P = 0.049, P = 0.004 and P < 0.001, respectively). In granulosa cells of patients with DOR, cholesterol-related substances such as coprostanone, 11A-acetoxyprogesterone and 17α-hydroxyprogesterone were significantly reduced (P = 0.0008, P = 0.0269, P = 0.0337, respectively). CYP19A1, a key steroidogenesis gene, was significantly reduced (P = 0.009). 17α-hydroxyprogesterone and oestradiol decreased (P = 0.004 and P = 0.039, respectively).

      Conclusion

      Decreased cholesterol metabolism affecting steroid hormone synthesis in granulosa cells might be a possible mechanism for DOR.

      Keywords

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      Biography

      Xiulan Yang, Associate Chief Physician of Obstetrics and Gynecology, graduated from Lanzhou University, majoring in Clinical Medicine. She specializes in gynaecological reproductive endocrinology as well as pathological and pregnancy.
      Key message
      Granulosa cell cholesterol metabolites and steroid hormone concentrations were decreased in diminished ovarian reserve (DOR) women. Cholesterol biosynthesis (IDI1, FDFT1, CYP51A1), uptake (SRB1, STARD1), homeostasis (SCAP) and steroid biosynthesis (CYP19A1) genes were down-regulated in granulosa cells of DOR women. Decreased cholesterol metabolism in granulosa cells may be linked to DOR.