{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T20:04:46Z","timestamp":1776629086186,"version":"3.51.2"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>This study compared pregnancy outcomes after frozen-thawed embryo transfer (FET) in infertile women aged &amp;lt;40 years with diminished ovarian reserve (DOR) versus normal ovarian reserve (NOR), incorporating exploratory analysis of potential endometrial aging factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective study, we analyzed the data of 1,362 patients aged &amp;lt;40 years who underwent FET between January and December 2024. Patients were categorized into two groups: the DOR (anti-M\u00fcllerian hormone [AMH] &amp;lt; 1.1 ng\/mL, n = 136) and NOR (AMH \u2265 1.1 ng\/mL, n = 1,226) groups. Pregnancy outcomes were compared after adjusting for confounding factors using inverse probability weighting. Additionally, exploratory immunohistochemical analysis of p16 expression was performed using endometrial samples from 16 patients (n = 8 per group).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After weighting, the clinical pregnancy rate was significantly lower in the DOR group than in the NOR group (47.0% vs. 58.3%, P = 0.040; odds ratio = 0.63, 95% confidence interval: 0.41\u20130.98). Exploratory analysis revealed that the expression of p16 was significantly higher in the endometrial cells of patients with DOR than in those of patients in the NOR group (P &amp;lt; 0.001). Furthermore, a trend toward lower clinical pregnancy rates was observed with higher p16 expression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These exploratory findings suggest that reduced pregnancy rates in young women with DOR may involve endometrial aging mechanisms; however, the preliminary nature and limited sample size for molecular analysis necessitate cautious interpretation and warrant validation in larger and well-controlled cohorts.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1608200","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T04:10:36Z","timestamp":1753762236000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical pregnancy outcomes in young women with diminished ovarian reserve undergoing frozen embryo transfer: a comprehensive analysis with exploratory insights into endometrial aging"],"prefix":"10.3389","volume":"16","author":[{"given":"Feng-xia","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui-xin","family":"Ming","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ka-li","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shan-jia","family":"Yi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue-fei","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-wei","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-hua","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2024.09.038","article-title":"Therapeutic management in women with a diminished ovarian reserve: a systematic review and meta-analysis of randomized controlled trials","volume":"123","author":"Conforti","year":"2025","journal-title":"Fertil Steril"},{"key":"B2","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1016\/j.fertnstert.2015.05.017","article-title":"Diminished ovarian reserve in the United States assisted reproductive technology population: diagnostic trends among 181,536 cycles from the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System","volume":"104","author":"Devine","year":"2015","journal-title":"Fertil Steril"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.35476","article-title":"Serum and follicular fluid thiol\/disulfide homeostasis in diminished ovarian reserve patients undergoing in vitro fertilization\/intracytoplasmic sperm injection treatment","volume":"15","author":"Erdo\u011fan","year":"2023","journal-title":"Cureus"},{"key":"B4","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1186\/s13048-023-01158-6","article-title":"Diminished ovarian reserve may not be associated with a poorer fresh cycle outcome in women <\u200938 years","volume":"16","author":"Jin","year":"2023","journal-title":"J Ovarian Res"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dey295","article-title":"Cumulative live birth rates and number of oocytes retrieved in women of advanced age. 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