Effects of Aging on the Human Ovary

Abstract

Objective To investigate the changes induced by age in the function and secretory pattern of the human ovary. Immunoreactive α -inhibin, E 2 , and P secretion in vivo and in vitro have been compared in two different populations. Design Prospective study. Women undergoing IVF-ET were divided into two groups according to age: group 1 (32.0±0.7years; mean±SEM) and group 2 (40.3±0.3years). Setting In vitro fertilization program at the Instituto Valenciano de Infertilidad. Patients A total of 33 infertile women with regular menses, undergoing IVF-ET. Interventions Follicle aspiration performed by transvaginal ultrasound. Four follicles per patient were aspirated in individual plastic tubes. Granulosa-luteal cells isolated with Percoll columns and cultured in vitro up to 4days in the presence of hCG. Main Outcome Measures In vitro fertilization parameters, serum levels of E 2 , immunoreactive α -inhibin, and P, as well as the secretion of immunoreactive α -inhibin and P by the cultured granulosa-luteal cells. Results Serum immunoreactive α -inhibin levels the day of ovum pick-up were significantly lower in group 2 compared with group 1. Incubation of cells for 96hours showed a significantly higher ability to accumulate immunoreactive α -inhibin in group 1 than 2. Human chorionic gonadotropin stimulated immunoreactive α -inhibin production after 96hours. Cells from younger women displayed a significantly higher ability to secrete P than cells from older women. Human chorionic gonadotropin was able to significantly stimulate P production in group 1. Conclusions These results confirm previous observations showing a reduced production of immunoreactive α -inhibin and steroids of ovaries from older women and suggest that a reduced cellular function, rather than a decrease in the follicular population, is the main mechanism by which these changes are produced.