To evaluate the effect of dehydroepiandrosterone (DHEA) on infertility patients with diminished ovarian reserve undergoing in vitro fertilization. This is a prospective study. Ninety-five patients with diminished ovarian reserve were included in this study. Of them, 42 patients were randomly allocated to the DHEA group, who received DHEA 75 mg daily for three consecutive menstrual cycles prior to IVF cycles, and 53 patients were allocated to the control group, who entered IVF cycles directly. All patients were treated with the same ovarian stimulation protocol. Follicular fluid samples from both groups were collected for bone morphogenetic protein-15 (BMP-15) and growth differentiation factor-9 (GDF-9). Fluid from the first aspirated follicle without any visible blood contamination was carefully collected. In addition, day 3 Blood samples were collected pre- and post-treatment of DHEA for serum anti-Mullerian hormone (AMH), follicle stimulating hormone (FSH) and estradiol (E2) in the DHEA group. The level of BMP-15 in follicular fluid samples from the DHEA group was significantly higher than that of the control samples (P=.000). Patients after DHEA treatment demonstrated a significantly higher level of AMH and a significantly lower level of FSH, E2 compared to themselves prior to DHEA therapy (P=.015; P=.036; P=.002; respectively). Moreover, the accumulated score of embryos was significantly higher in the DHEA group (P=.033). These observations confirm the beneficial effect of DHEA for infertility patients with diminished ovarian reserve. ChiCTR-TRC-14005002

Melatonin (MT) can improve the effect of cryopreservation on oocytes by suppressing oxidative stress and maintaining the permeability of the oolemma. In this study, MT was firstly applied to human oocytes’ cryopreservation to explore the effect of prolonged cryopreservation on developmental competence and its role. Collected in vitro-matured human oocytes were cryopreserved in MT-containing or MT-free medium for 0 and 6 months; after warming, viable oocytes were assessed for developmental viability, intracellular protein expression, mitochondrial function, and oxidation-antioxidant system. Meanwhile, fresh oocytes were set as the control. The results showed that with the extension of cryopreservation time, the developmental competence of oocytes gradually declined, accompanied by the down-regulation of most mitochondrial function-related proteins, the reduction in ATP and GSH production, the increase in ROS accumulation, and the aggravation of the imbalance of ROS/GSH in oocytes. However, the participation of MT seemed to effectively mitigate these negative effects. Therefore, we speculate that melatonin may maintain normal ATP production and ROS/GSH balance in cryopreserved oocytes by protecting mitochondrial function and inhibiting oxidative damage, thereby effectively maintaining the developmental competence of human oocytes in prolonged cryopreservation.

Zona pellucida (ZP) abnormalities are the cause of low fertility or infertility, agar-like ZP is more common in abnormal ZP. The purpose of this exploration is to systematically analyze the fertilization competence of agar-like ZP oocytes, the development characteristics of subsequent embryos as well as the results of embryo transfer, aiming to explore effective clinical treatment strategies. A total of 58 patients with agar-like ZP were set as the case group and the control group involved 3866 patients, in which the patients’ oocytes presented normal ZP. BMI, basal hormone levels, and hormone levels were similar in both groups. The case patients suffered significantly longer infertility years than control (p<0.05), and most patients were diagnosed with pelvic inflammatory diseases. A distinct difference was observed in the structure of oocyte corona cumulus complexes between the two groups. The embryo development parameters, which include the rates of cleavage, high-quality embryo, blastocyst, and high-quality blastocyst in the case group were greatly lower than that in the control group (p<0.05). The rates of cumulative clinical pregnancy and live birth were comparable between the two groups. In the subsequent follow-up, thirty-four of the 58 patients receiving intracytoplasmic single sperm injection (ICSI) or early rescue ICSI (R-ICSI) treatment successfully gave birth to babies, and all of the newborns were with no neonatal defects. In addition, the fertilization rate of the R-ICSI group was significantly lower than that of the ICSI group (p<0.05). The occurrence of agar-like ZP impairs the development competence of human oocytes, however, the human oocytes with agar-like ZP can develop into healthy offspring, and an ICSI regimen is the optimal treatment strategy for them.

Purpose: Graphene oxide (GO) has promising biomedical applications, but its potential toxicity to the female reproductive system is underexplored. This study investigates the short-term effects of a single dose of GO nanosheets on human ovarian granulosa cells, focusing on mitochondrial damage. Materials and Methods: First, cell viability was detected by CCK-8 and apoptosis was detected by flow cytometry to assess the cytotoxicity of GO on KGN. Second, reactive oxygen species (ROS), mitochondrial membrane potential (MMP), and mitochondrial morphology were observed by confocal microscopy, mitochondrial and sub-mitochondrial structure by transmission electron microscopy (TEM), quantitative analysis of ATP and mitochondrial complex I enzyme activity by luminosity value and autophagy by flow cytometry to assess the mitochondrial toxicity of GO on KGN cells. Results: The 72h half-maximum effective concentration (EC50) value of GO was determined to be 29.73 μg/mL. GO induced cell death in a dose-dependent manner, with significant effects on cell viability even at low doses (1 μg/mL). Exposure to low GO concentrations resulted in abnormal mitochondrial morphology and function, including mitochondrial breakage, membrane damage, reduced mitochondrial cristae, enhanced autophagy, decreased ATP production, decreased MMP, and decreased enzymatic activity of mitochondrial complex I. Mitochondrial function returned to normal levels on day 7 after KGN cells left the GO-exposed environment. Conclusion: This study demonstrates that short-term exposure to low-dose GO causes mitochondrial damage in human ovarian granulosa cells, highlighting the need for further research on the safety of GO, particularly regarding its potential effects on reproductive health. However, GO-induced transient mitochondrial damage is highly likely to negatively affect ovarian reserve function, which needs to be further verified in animal models.