• Xiaofei Xu, Xinxia Chen, Xiruo Zhang, Yixun Liu, Zhao Wang, Peng Wang, Yanzhi Du, Yingying Qin, and Zi-Jiang Chen.
• Center for Reproductive Medicine, Provincial Hospital Affiliated to Shandong University, No. 324 Jingwu Road, Jinan 250021, P.R. China.
• Hum. Reprod. 2017 Jan 1; 32 (1): 201-207.

Study QuestionAre telomere length and telomerase activity associated with biochemical primary ovarian insufficiency (POI)?Summary AnswerShortened telomere length and diminished telomerase activity were associated with biochemical POI.What Is Known AlreadyPOI is a result of pathological reproductive aging and encompasses occult, biochemical and overt stages. Studies have indicated telomere length as a biomarker for biological aging.Study Design, Size, DurationA total of 120 patients with biochemical POI and 279 control women were recruited by the Center for Reproductive Medicine of Shandong University.Participants/Materials, Setting, MethodsTelomere length in peripheral blood leukocytes (LTL) and granulosa cells (GTL) was measured using a modified Quantitative Polymerase Chain Reaction technique. The relative telomerase activity (RTA) in granulosa cells was detected using a modified quantitative-telomeric repeat amplification protocol assay.Main Results And The Role Of ChanceAfter adjusting for age, patients with biochemical POI (n = 120) exhibited significantly shorter LTLs (0.75 ± 0.09 vs 1.79 ± 0.12, P < 0.001; OR = 0.54, 95% CI = 0.43-0.68) and GTLs (0.78 ± 0.09 vs 1.90 ± 0.23, P < 0.001; OR = 0.54, 95% CI = 0.41-0.70) than the controls (n = 279 for LTLs; n = 90 for GTLs). Significantly diminished RTAs in granulosa cells were detected in patients with biochemical POI (n = 31) compared with the controls (n = 38) (1.57 ± 0.59 vs 4.63 ± 0.93, P = 0.025; OR = 0.84, 95% CI = 0.72-0.98).Large Scale DataN/A.Limitations, Reasons For CautionThe cross-sectional nature of this study might have its limit in telomere length as well as telomerase activity along with the progressing decline in ovarian function.Wider Implications Of The FindingsThese findings suggest that telomere length and telomerase activity may be considered as indicators for progression of ovarian decline.Study Funding/Competing InterestsThis research was supported by the National Basic Research Program of China (973 Program) (2012CB944700), Science research foundation item of no-earnings health vocation (201402004) and the National Natural Science Foundation of China (31471352, 81270662, 81471509, 81300461, 81522018). The authors have no potential conflict of interest to declare.© The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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