Evidence map›Paper›PMID 29981579›Full record

ArticleReproductive biology and endocrinology : RB&E2018

FMR1 expression in human granulosa cells increases with exon 1 CGG repeat length depending on ovarian reserve.

Julia Rehnitz, Diego D Alcoba, Ilma S Brum, Jens E Dietrich, Berthe Youness, Katrin Hinderhofer, Birgitta Messmer, Alexander Freis, Thomas Strowitzki, Ariane Germeyer

Open access · goldAbstract read
In one paragraph

Article in Reproductive biology and endocrinology : RB&E, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 58 citations in OpenAlex.

  1. Article
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  4. Beyond Repetition: The Role of Gray Zone Alleles in the Upregulation ofInternational journal of molecular sciences · 2025
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  5. Role of epigenetic regulation in diminished ovarian reserve.Journal of assisted reproduction and genetics · 2025
    Review
  6. Review
  7. Regulation of Bone Morphogenetic Protein Receptor Type II Expression byInternational journal of molecular sciences · 2024
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  10. GDF9Cell communication and signaling : CCS · 2024
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  11. Article
  12. Journal of clinical medicine · 2021
    Article
  13. Review
  14. Article
  15. Genetics of human female infertility†.Biology of reproduction · 2019
    Review
  16. Review
  17. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 2 countries.

Julia RehnitzReproduction Genetics Unit, Department of Gynecological Endocrinology and Fertility Disorders, University Women's Hospital, Heidelberg, Germany. julia.rehnitz@med.uni-heidelberg.de.
Diego D AlcobaReproduction Genetics Unit, Department of Gynecological Endocrinology and Fertility Disorders, University Women's Hospital, Heidelberg, Germany.
Ilma S BrumDepartment of Physiology, Institute of Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Jens E DietrichDepartment of Gynecological Endocrinology and Fertility Disorders, University Women's Hospital, Heidelberg, Germany.
Berthe YounessReproduction Genetics Unit, Department of Gynecological Endocrinology and Fertility Disorders, University Women's Hospital, Heidelberg, Germany.
Katrin HinderhoferLaboratory of Molecular Genetics, Institute of Human Genetics, Heidelberg University, Heidelberg, Germany.
Birgitta MessmerReproduction Genetics Unit, Department of Gynecological Endocrinology and Fertility Disorders, University Women's Hospital, Heidelberg, Germany.
Alexander FreisDepartment of Gynecological Endocrinology and Fertility Disorders, University Women's Hospital, Heidelberg, Germany.
Thomas StrowitzkiDepartment of Gynecological Endocrinology and Fertility Disorders, University Women's Hospital, Heidelberg, Germany.
Ariane GermeyerDepartment of Gynecological Endocrinology and Fertility Disorders, University Women's Hospital, Heidelberg, Germany.
University Hospital Heidelberg · DEUniversidade Federal do Rio Grande do Sul · BRHeidelberg University · DE

Funding

Deutsche Forschungsgemeinschaft RE 3647/1-1financial support by Deutsche Forschungsgemeinschaft within the funding programme Open Access Publishing, by the Baden-Württemberg Ministry of Science, Research and the Arts and by Ruprecht-Karls-Universität Heidelberg IN-1150438
6 · The paper itself

Abstract

backgroundFragile-X-Mental-Retardation-1- (FMR1)-gene is supposed to be a key gene for ovarian reserve and folliculogenesis. It contains in its 5'-UTR a triplet-base-repeat (CGG), that varies between 26 and 34 in general population. CGG-repeat-lengths with 55-200 repeats (pre-mutation = PM) show instable heredity with a tendency to increase and are associated with premature-ovarian-insufficiency or failure (POI/POF) in about 20%. FMR1-mRNA-expression in leucocytes and granulosa cells (GCs) increases with CGG-repeat-length in PM-carriers, but variable FMR1-expression profiles were also described in women with POI without PM-FMR1 repeat-length. Additionally, associations between low numbers of retrieved oocytes and elevated FMR1-expression levels have been shown in GCs of females with mid-range PM-CGG-repeats without POI. Effects of FMR1-repeat-lengths-deviations (n < 26 or n > 34) below the PM range (n < 55) on ovarian reserve and response to ovarian stimulation remain controversial.

methodsWe enrolled 229 women undergoing controlled ovarian hyperstimulation for IVF/ICSI-treatment and devided them in three ovarian-response-subgroups: Poor responder (POR) after Bologna Criteria, polycystic ovary syndrome (PCO) after Rotterdam Criteria, or normal responder (NOR, control group). Subjects were subdivided into six genotypes according to their be-allelic CGG-repeat length. FMR1-CGG-repeat-length was determined using ALF-express-DNA-sequencer or ABI 3100/3130 × 1-sequencer. mRNA was extracted from GCs after follicular aspiration and quantitative FMR1-expression was determined using specific TaqMan-Assay and applying the ΔΔCT method. Kruskall-Wallis-Test or ANOVA were used for simple comparison between ovarian reserve (NOR, POR or PCO) and CGG-subgroups or cohort demographic data. All statistical analysis were performed with SPSS and statistical significance was set at p ≤ 0.05.

resultsA statistically significant increase in FMR1-mRNA-expression-levels was detected in GCs of PORs with heterozygous normal/low-CGG-repeat-length compared with other genotypes (p = 0.044).

conclusionFemale ovarian response may be negatively affected by low CGG-alleles during stimulation. In addition, due to a low-allele-effect, folliculogenesis may be impaired already prior to stimulation leading to diminished ovarian reserve and poor ovarian response. A better understanding of FMR1 expression-regulation in GCs may help to elucidate pathomechanisms of folliculogenesis disorders and to develop risk-adjusted treatments for IVF/ICSI-therapy. Herewith FMR1-genotyping potentially provides a better estimatation of treatment outcome and allows the optimal adaptation of stimulation protocols in future.

Indexed as

Repetitive Sequences, Nucleic AcidExonsFemaleFragile X Messenger Ribonucleoprotein 1Gene Expression ProfilingGene Expression RegulationGranulosa CellsHumansOvarian ReserveFMR1 protein, humanFragile X Messenger Ribonucleoprotein 1FMR1 CGG repeat lengthFMR1 expressionFMR1 genotypeGranulosa cells

Identifiers

PMID29981579
PMCPMC6035797
OpenAlexW2827039195

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.