von Wolff Michael, Schneider Sophie, Kollmann Zahraa, Weiss Benedicte, Bersinger Nick A
University Women's hospital, Division of Gynaecological Endocrinology and Reproductive Medicine, Effingerstrasse 102, Berne 3010, Switzerland.
Reprod Biol Endocrinol. 2013 Sep 4;11:87. doi: 10.1186/1477-7827-11-87.
In vitro fertilization involves high dosage gonadotropin stimulation, which apparently has some negative impact on follicular endocrine function. As chorionic gonadotropin stimulation has been shown to increase the blood-follicular permeability in animal models, this raises the question if such an effect also applies to gonadotropins in humans, possibly affecting the endocrine follicular milieu.
Follicular fluid and serum were collected at the time of follicular aspiration in in vitro fertilisation without (Natural cycle IVF, n = 24) and with (conventional gonadotropin stimulated IVF, n = 31) gonadotropin stimulation. The concentration of the extra-ovarian hormones prolactin and cortisol were analysed by immunoassays.
Median serum prolactin and cortisol concentrations were 12.3 ng/mL and 399 nmol/L without versus 32.2 ng/mL and 623 nmol/L with gonadotropin stimulation. The corresponding concentrations in follicular fluid were 20.6 ng/mL and 445 nmol/L versus 28.8 ng/ml and 456 nmol/L for prolactin and cortisol. As a consequence, mean follicular fluid:serum ratios were significantly reduced under gonadotropin stimulation (prolactin p = 0.0138, cortisol p = 0.0001). As an enhanced blood-follicular permeability and transportation, induced by gonadotropin stimulation, would result in increased instead of decreased follicular fluid:serum ratios as found in this study, it can be assumed that this does not affect extra-ovarian protein and steroid hormones as illustrated by prolactin and cortisol.
The model of serum follicular fluid:serum ratio of hormones, produced outside the ovaries, did not reveal a gonadotropin induced increased blood-follicular transportation capacity. Therefore it can be assumed that the effect of gonadotropins on follicular endocrine function is not due to an increased ovarian permeability of extra-ovarian hormones.
体外受精涉及高剂量促性腺激素刺激，这显然对卵泡内分泌功能有一些负面影响。由于在动物模型中已证明绒毛膜促性腺激素刺激会增加血液 - 卵泡通透性，这就提出了一个问题，即这种效应是否也适用于人类的促性腺激素，可能会影响卵泡内分泌微环境。
在体外受精取卵时收集卵泡液和血清，其中一组未接受促性腺激素刺激（自然周期体外受精，n = 24），另一组接受促性腺激素刺激（传统促性腺激素刺激体外受精，n = 31）。通过免疫测定法分析卵巢外激素催乳素和皮质醇的浓度。
未接受促性腺激素刺激时血清催乳素和皮质醇浓度中位数分别为12.3 ng/mL和399 nmol/L，接受促性腺激素刺激时分别为32.2 ng/mL和623 nmol/L。卵泡液中催乳素和皮质醇的相应浓度分别为20.6 ng/mL和445 nmol/L，以及28.8 ng/ml和456 nmol/L。因此，在促性腺激素刺激下，平均卵泡液：血清比值显著降低（催乳素p = 0.0138，皮质醇p = 0.0001）。由于促性腺激素刺激引起的血液 - 卵泡通透性和转运增强会导致卵泡液：血清比值升高而非降低，如本研究中所发现的，因此可以假设这不会影响卵巢外蛋白质和类固醇激素，如催乳素和皮质醇所示。
卵巢外产生的激素的血清卵泡液：血清比值模型未显示促性腺激素诱导的血液 - 卵泡转运能力增加。因此可以假设促性腺激素对卵泡内分泌功能的影响不是由于卵巢外激素的卵巢通透性增加所致。
