The expression of CD24 in granulosa cells of patients with polycystic ovary syndrome affects the clinical outcome of assisted reproductive technology

Abstract Polycystic ovary syndrome（PCOS）is one of the most common reproductive endocrine disorders affecting approximately 5-20% of women in the reproductive age. Patients with PCOS also have chronic inflammation and oxidative stress, which can lead to abnormalities in the follicular development microenvironment, resulting in the accumulation of small follicles in the ovary, polycystic ovarian morphology, and ovulatory dysfunction. Some studies have shown that CD24 has multiple immune functions and plays an important role in the development of autoimmune diseases, inflammatory responses, and tumors. Moreover, recent studies indicated that CD24 plays a critical role in ovulation and may be related to PCOS. However, there is a lack of clinical data support, and the mechanism by which CD24 affects PCOS remains unclear. In this study, we explored CD24 differential expression in ovarian granulosa cells of patients with PCOS infertility by SCRB-Seq (single cell RNA barcoding and sequencing). Furthermore, increased CD24 mRNA level correlated with serum AMH in ovarian granulosa cells and BMI index. In addition, there was a significant positive correlation between granulosa cell CD24 mRNA expression and numbers of retrieved oocytes, two-pronuclear zygotes (2PN), transferable embryos, good quality embryos and cleaved embryos. At the same time, we found that CD24 mRNA is significantly higher in pregnant patients than in non-pregnant ones in granulosa cells, suggesting that CD24 is associated with PCOS, and it may influence the clinical outcome of PCOS patients undergoing IVF.