DIMINISHED ALPHA-INHIBIN MESSENGER-RIBONUCLEIC-ACID IN IN-VITRO FERTILIZATION-EMBRYO TRANSFER POOR RESPONDERS REFLECTS DECLINING FOLLICLE RESERVE

Objectives: To quantitate and compare granulosa cell alpha-inhibin mes senger RNA (mRNA) levels in IVF-ET poor and good responders and thereb y learn how alpha-inhibin mRNA levels change in states of diminished o varian responsiveness. Design: Ribonucleic acid analysis of stored lut einized granulosa cell samples.Setting: Academic tertiary care institu tion. Patients: Fifty-three women undergoing follicle aspiration for I VF-ET were studied. Patients were classified as poor responders (n = 1 6) or good responders (n = 37) according to their E(2) concentration o n the day of hCG; the E(2) of poor responders was <1,000 pg/mL (3,671 pmol/L) and that of good responders was greater than or equal to 1,000 pg/mL (3,671 pmol/L). Main Outcome Measures: Messenger RNA levels wer e measured using dot blot RNA analysis. The following parameters were determined or derived: total mRNA levels, total alpha-inhibin mRNA lev els, alpha-inhibin mRNA per follicle, and proportional alpha-inhibin m RNA as the ratio of alpha-inhibin mRNA:total mRNA. Results: Proportion al alpha-inhibin mRNA and alpha-inhibin mRNA per follicle were not sig nificantly different between poor responders and good responders. Tota l mRNA and total alpha-inhibin mRNA levels, however, were diminished s ignificantly in poor responders. Conclusions: The observations that pr oportional alpha-inhibin mRNA and alpha-inhibin mRNA per follicle do n ot significantly change in poor responders, whereas total alpha-inhibi n mRNA does, indicate that the decrease in total alpha-inhibin mRNA in poor responders reflects a decreased pool of total mRNA, likely becau se of a reduction in follicle number. These findings are in contrast t o other recent reports that describe a change in granulosa cell functi on accompanying states of decreased ovarian responsiveness.