Miró F, Sampaio M C, Tarin J J, Pellicer A
Instituto Valenciano de Infertilidad, Valencia University School of Medicine, Spain.
Gynecol Endocrinol. 1992 Jun;6(2):77-84. doi: 10.3109/09513599209046389.
We have previously observed impaired progesterone accumulation in vitro in response to human chorionic gonadotropin (hCG) by cells pretreated in vivo with a gonadotropin releasing hormone analog (GnRH-a). The present study was conducted in order to evaluate different protocols for GnRH-a in in vitro fertilization (IVF), employing two different available analogs. Granulosa-luteal cells were collected at ovum pick-up and stimulated with hCG. Buserelin (Bus) was employed as long (Bus-L) and short (Bus-S) protocol, and Leuprolide (Leu) was also used as long (Leu-L) and short (Leu-S) protocol. Progesterone accumulation in vitro was compared with cells treated with clomiphene citrate (CC) and gonadotropins. Maximal progesterone production was observed on culture day 6 using Bus-L in comparison to day 4 when clomiphene citrate was employed. While Leu-S showed a similar pattern of progesterone accumulation to clomiphene citrate, Leu-L and Bus-S had an intermediate pattern. The response to hCG was maximal on day 4 for the clomiphene citrate- and Leu-S-treated cells, while the rest of the protocols had a peak on day 6. In addition, hCG consistently stimulated progesterone production in all protocols except in Bus-L. These results confirm an altered progesterone accumulation in vitro when GnRH-a are used. The effect seems to be more evident in long protocols, especially when buserelin is used, suggesting a higher accumulation of the analog in follicular fluid.
我们之前观察到,体内用促性腺激素释放激素类似物(GnRH-a)预处理过的细胞,在体外对人绒毛膜促性腺激素(hCG)的反应中,孕酮积累受损。本研究旨在评估体外受精(IVF)中使用GnRH-a的不同方案,采用两种不同的可用类似物。在取卵时收集颗粒黄体细胞,并用hCG刺激。布舍瑞林(Bus)采用长效(Bus-L)和短效(Bus-S)方案,亮丙瑞林(Leu)也采用长效(Leu-L)和短效(Leu-S)方案。将体外孕酮积累与用枸橼酸氯米芬(CC)和促性腺激素处理的细胞进行比较。与使用枸橼酸氯米芬时的第4天相比,使用Bus-L在培养第6天观察到最大孕酮产生。虽然Leu-S显示出与枸橼酸氯米芬相似的孕酮积累模式,但Leu-L和Bus-S具有中间模式。枸橼酸氯米芬和Leu-S处理的细胞在第4天对hCG的反应最大,而其余方案在第6天达到峰值。此外,除Bus-L外,hCG在所有方案中均持续刺激孕酮产生。这些结果证实,使用GnRH-a时体外孕酮积累发生改变。这种作用在长效方案中似乎更明显,尤其是使用布舍瑞林时,表明该类似物在卵泡液中积累更多。