Db. Seifer et al., APOPTOSIS AS A FUNCTION OF OVARIAN RESERVE IN WOMEN UNDERGOING IN-VITRO FERTILIZATION, Fertility and sterility, 66(4), 1996, pp. 593-598
Objective: To test the hypothesis that preovulatory follicles from wom
en with diminished ovarian reserve contain fewer numbers of luteinized
granulosa cells and have a greater percentage of cells undergoing apo
ptosis as compared with women with uncompromised ovarian reserve under
going superovulation for IVF-ET.Design: Comparative study. Setting: Ac
ademic clinical practice. Patients: Luteinized granulosa cell counts w
ere determined from follicular aspirates harvested from 19 women with
day 3 serum FSH less than or equal to 6 mIU/mL (conversion factor to S
I unit, 1.00) and from 15 women with FSH levels greater than or equal
to 10 mIU/mL. The second part examined the percent of proliferating an
d apoptotic cells harvested from nine women with day 3 serum FSH less
than or equal to 6 mIU/mL mt and from eight women with FSH levels grea
ter than or equal to 10 mIU/mL. Main Outcome Measures: Cell counts by
hemacytometer and percent of proliferating and of apoptotic granulosa
cells by flow cytometry. Results: The mean number of viable cells isol
ated per follicle were 2.7 x 10(5) (95% confidence interval [CI] 2.3 t
o 3.1 x 10(5)) from the low FSH group and 1.8 x 10(5) (95% CI 1.4 to 2
.3 x 10(5)) from the high FSH group. Although the percentage of prolif
erating cells was the same, the mean percentage of apoptotic cells was
0.5% (95% CI 0.2% to 1.4%) from the low group and 2.0% (95% CI 1.1% t
o 3.7%) from the high group. Conclusions: Women undergoing TVF with da
y 3 serum FSH greater than or equal to 10 mIU/mL have preovulatory fol
licles with fewer luteinized granulosa cells and an increase in the pe
rcentage of cells undergoing apoptosis as compared with women with day
3 serum FSH less than or equal to 6 mIU/mL.