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Follicular fluid hormonal profile and cumulus cell gene expression in controlled ovarian hyperstimulation with recombinant FSH: effects of recombinant LH administration

  • ASSISTED REPRODUCTION TECHNOLOGIES
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Abstract

Purpose

Down-regulation with gonadodropin-releasing agonist (GnRH-a) protocol during IVF stimulation leads to a severe endogenous LH suppression, which may affect the follicular development. The aim of the study was to evaluate the effects of recombinant LH (r-LH) administration, during late follicular development stages, in recombinant FSH (r-FSH) stimulated cycles on follicular fluid (FF) parameters and on cumulus cell quality.

Methods

Twenty patients undergoing IVF were stimulated in a long GnRH agonist protocol with r-FSH alone or with r-LH supplementation when the leading follicle reached diameter of 14 mm. FF was collected at the time of oocyte retrieval from 32 follicles ≥ 18 mm. Serum FSH, LH, estradiol (E2), and progesterone (P4) were evaluated on the day of hCG administration. Intra-follicular E2, P4, AMH and TGF-β were assayed. Total RNA from 18 individual cumuli was isolated for gene expression analyses.

Results

R-LH increased FF P4 levels. FF TGF-β levels and PTGS2 and HAS2 expression in cumulus cells (CCs) positively correlated with increased P4 levels observed in FFs, while a negative correlation was found between P4 and AMH levels.

Conclusions

FF positive correlation between P4 and TGF-β levels and CC expression of PTGS2 and HAS2 suggest an association with a better follicle quality. In addition, our data suggest that late follicular phase r-LH supplementation leads to a more advanced stage of follicular maturation.

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Acknowledgments

MLECs were kindly provided by Dr.D.B. Rifkin, New York University School of Medicine, New York. We thank Dr. Giovanni Ruvolo, Centro di Biologia della Riproduzione, Palermo, Italy, for isolating cumulus cells; Dr. Paola Canipari for reviewing the English in the manuscript.

This study was supported by “La Sapienza” University of Rome Ateneo Federato 2009–2010 to R.C.

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Author notes

  1. Marzia Barberi

    Present address: Tecnobios Procreazione, Centre for Reproductive Health, Bologna, Italy

Authors and Affiliations

  1. Department of Anatomy, Histology, Forensic Medicine and Orthopedic, Section of Histology, Sapienza University of Rome, Rome, Italy

    Marzia Barberi, Maria Beatrice Morelli & Rita Canipari

  2. Section of Gynecology and Obstetrics, Department of Surgical Sciences, University Tor Vergata, Rome, Italy

    Beatrice Ermini

  3. C.I.P.A, Rome, Italy

    Michele Ermini

  4. Department of Health Sciences, University of L’Aquila, L’Aquila, Italy

    Sandra Cecconi

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  1. Marzia Barberi
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  2. Beatrice Ermini
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Corresponding author

Correspondence to Rita Canipari.

Additional information

Marzia Barberi and Beatrice Ermini contributed equally to this work Sandra Cecconi and Rita Canipari contributed equally as co-senior authors

Capsule LH supplementation to an IVF stimulation with r-FSH leads to a more advanced stage of follicular maturation in the study population which presented normal or low LH levels after pituitary GnRH-a suppression.

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Barberi, M., Ermini, B., Morelli, M.B. et al. Follicular fluid hormonal profile and cumulus cell gene expression in controlled ovarian hyperstimulation with recombinant FSH: effects of recombinant LH administration. J Assist Reprod Genet 29, 1381–1391 (2012). https://doi.org/10.1007/s10815-012-9893-9

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