Oxidative stress and inflammatory markers in ovarian follicular fluid of women with diminished ovarian reserve during in vitro fertilization

Background: Follicular microenvironment has been proposed as an important factor for oocyte grown and maturation. We sought to evaluate the oxidative stress and inflammatory levels in follicular fluid and association with embryo quality in patients with diminished ovarian reserve (DOR). Methods: The current research included 46 DOR cases and 56 NOR cases.Twelve representative oxidative stress markers and eight representative inflammatory factors were measured in thefollicular fluid (FF). Results: Oxidative stress markers T-GSH was decreased in the FF from women with DOR compared with that in NOR group ( P = 0.041). More modest differences were observed for reduced GSH and reduced GSH/GSSG. Women with DOR compared to controls had higher level of TNF-α ( P = 0.000) and lower level of IL-18 ( P = 0.013). Correlation analysis revealed that GSSG was negatively correlated with normal fertilization ratein NOR group (r = -0.358, P = 0.008), and GSH was negatively correlated with normal fertilization rate in DOR group (r = -0.299, P = 0.049). Moreover, as the regression analysis data showed, the GSSG level was significantly associated with embryo quality indicator. Conclusions: DOR was accompanied by increased oxidative stress and inflammatory levels in the FF. Follicular development of women with DOR might be influenced by unusual IL-18 level in the FF. And oxidative stress level in theFF contributed to embryo quality.