Edgar D H, Whalley K M, Gemmell J A, James G B, Mills J A
Unit of Reproductive Medicine, Ninewells Hospital and Medical School, Dundee, UK.
Hum Reprod. 1991 Feb;6(2):198-202. doi: 10.1093/oxfordjournals.humrep.a137305.
The pregnancy rate in patients undergoing assisted conception treatment following pituitary desensitization with GnRH analogue and ovarian stimulation with gonadotrophins has been reported to be higher when ovarian function is supported in the luteal phase by exogenous human chorionic gonadotrophin (HCG). In the present study, we have examined the effects of culturing monolayers of granulosa cells, collected from such patients at oocyte retrieval, for various time intervals in the presence or absence of HCG on their subsequent ability to secrete progesterone (P4) either spontaneously or in response to further challenge with HCG. When cultured in the absence of HCG, granulosa cells demonstrated a rapid decline in both the spontaneous P4 secretion rate and the ability to secrete P4 in response to HCG. Maintenance in the presence of HCG inhibited the rapid decline in ability to secrete P4 spontaneously and also significantly enhanced the ability to respond to subsequent HCG stimulation. These results suggest that HCG support in the luteal phase in GnRH analogue-treated patients may have a cellular basis for its action both in maintenance of P4 secretion and also in rendering the corpus luteum more sensitive to rescue by conceptus-derived HCG.
据报道，在用促性腺激素释放激素（GnRH）类似物进行垂体脱敏并使用促性腺激素进行卵巢刺激后接受辅助受孕治疗的患者中，当在黄体期通过外源性人绒毛膜促性腺激素（HCG）支持卵巢功能时，妊娠率更高。在本研究中，我们检测了从这些患者取卵时收集的颗粒细胞单层在有或无HCG的情况下培养不同时间间隔后，其随后自发分泌孕酮（P4）或对HCG进一步刺激作出反应分泌P4的能力受到的影响。在无HCG的情况下培养时，颗粒细胞自发P4分泌率和对HCG作出反应分泌P4的能力均迅速下降。在有HCG的情况下维持培养可抑制自发分泌P4能力的快速下降，并且还显著增强了对随后HCG刺激作出反应的能力。这些结果表明，在接受GnRH类似物治疗的患者的黄体期给予HCG支持，可能在维持P4分泌以及使黄体对来自孕体的HCG的挽救作用更敏感方面具有细胞水平的作用基础。
