In vitro орчин дах үр хөврөлийн хөгжил болон фолликулын шингэн дэх өөх тосны үзүүлэлт хоорондын хамаарлыг судалсан нь

Abstract

Background: In female reproduction, follicular fluid (FF) is the natural environment for the final phase of oocyte maturation. Therefore, its composition is essential for oocyte growth, quality, and FF metabolic profile variations. One of the major factors affecting IVF treatment is follicle development. Correctly recognizing the composition of follicular fluid, its physiological role and involvement is important to create a basic understanding of the theory of oocyte and follicular development, thereby increasing the results of IVF treatment. Aim: To determine whether follicular fluid (FF) cholesterol level affect oocyte maturation and embryo development. Materials and Methods: This analysis includes 74 oocytes were obtained from 30 women with tubal infertility who underwent ovarian stimulation via clomiphene citrare for in vitro fertilization at “RMC” IVF center of Mongolia, from August 2020 to July 2022. The study population included semen samples except men with azoospermia, surgically retrieved samples. Cholesterol concentrations were measured by enzymatic methods in follicular fluid. The oocytes were split into two groups based on the mean levels of intrafollicular cholesterol (0.19 mmol/l) low cholesterol level (LHL, n=48) and high cholesterol level (HHL, n=26). We compared oocyte maturation, fertilization, cleavage grade, blastocyst formation and grading using Pearson Chi-Square. Ethical approval was obtained from the Research Ethics Committee of the MNUMS. Results: The mean age of participants were 38.0±4.4 yrs (mean±sd) and mean retrieved oocytes were recorded. A total of 74 oocytes and 23 blastocyst were eligible for the analysis. There were no diffrences for oocyte maturation, fertilization, cleavage grade, blast formation between two groups(p>0.05). Good blastocysts (А, B) were higher LHL group (66.7%, n=10) than HHL group (12.5%, n=1) and poor blastocysts (C,D,E) were lower LHL group (33.3%, n=5) than HHL group (87.5%, n=7) (p=0.013). The blastocysts grade appears to be more dependent intrafollicular cortisol level, with the odds 14 (OR:14, CI: 1.3-147.4, p<0.05). Conclusions: A high level of cholesterol in the follicular fluid increases the risk of poor grade blastocysts (grades C, D, E) by 14.0 times, probably because the inflammatory and oxidative processes caused by excessive accumulation of cholesterol affect the function of the ovary, which in turn affects the quality and further development of the oocyte.