O'Brien Travis J, Kalmin Mariah M, Harralson Arthur F, Clark Adam M, Gindoff Ian, Simmens Samuel J, Frankfurter David, Gindoff Paul
Reprod Biol Endocrinol. 2013 Jul 25;11:71. doi: 10.1186/1477-7827-11-71.
The aim of this study was to determine the relationship between a purported luteinizing hormone/chorionic gonadotropin (LHCGR) high function polymorphism (rs4539842/insLQ) and outcome to controlled ovarian hyperstimulation (COH).
This was a prospective study of 172 patients undergoing COH at the Fertility and IVF Center at GWU. DNA was isolated from blood samples and a region encompassing the insLQ polymorphism was sequenced. We also investigated a polymorphism (rs4073366 G > C) that was 142 bp from insLQ. The association of the insLQ and rs4073366 alleles and outcome to COH (number of mature follicles, estradiol level on day of human chorionic gonadotropin (hCG) administration, the number of eggs retrieved and ovarian hyperstimulation syndrome (OHSS)) was determined.
Increasing age and higher day 3 (basal) FSH levels were significantly associated with poorer response to COH. We found that both insLQ and rs4073366 were in linkage disequilibrium (LD) and no patients were homozygous for both recessive alleles (insLQ/insLQ; C/C). The insLQ variant was not significantly associated with any of the main outcomes to COH. Carrier status for the rs4073366 C variant was associated (P = 0.033) with an increased risk (OR 2.95, 95% CI = 1.09-7.96) of developing OHSS.
While age and day 3 FSH levels were predictive of outcome, we found no association between insLQ and patient response to COH. Interestingly, rs4073366 C variant carrier status was associated with OHSS risk. To the best of our knowledge, this is the first report suggesting that LHCGR genetic variation might function in patient risk for OHSS.
本研究旨在确定一种所谓的促黄体生成素/绒毛膜促性腺激素(LHCGR)高功能多态性(rs4539842/insLQ)与控制性卵巢刺激(COH)结局之间的关系。
这是一项对172例在乔治华盛顿大学生育与体外受精中心接受COH治疗的患者进行的前瞻性研究。从血样中提取DNA,并对包含insLQ多态性的区域进行测序。我们还研究了一个距insLQ 142 bp的多态性(rs4073366 G>C)。确定了insLQ和rs4073366等位基因与COH结局(成熟卵泡数量、人绒毛膜促性腺激素(hCG)给药日的雌二醇水平、取卵数量和卵巢过度刺激综合征(OHSS))之间的关联。
年龄增加和第3天(基础)FSH水平升高与对COH的反应较差显著相关。我们发现insLQ和rs4073366均处于连锁不平衡(LD)状态,且没有患者两个隐性等位基因(insLQ/insLQ;C/C)均为纯合子。insLQ变异与COH的任何主要结局均无显著关联。rs4073366 C变异的携带者状态与发生OHSS的风险增加相关(P = 0.033)(OR 2.95,95%CI = 1.09 - 7.96)。
虽然年龄和第3天FSH水平可预测结局,但我们发现insLQ与患者对COH的反应之间无关联。有趣的是,rs4073366 C变异携带者状态与OHSS风险相关。据我们所知,这是首次表明LHCGR基因变异可能在患者OHSS风险中起作用的报告。