促性腺激素刺激降低卵泡液激素浓度，并破坏其与卵丘细胞 mRNA 的定量关联。

Gonadotrophin stimulation reduces follicular fluid hormone concentrations and disrupts their quantitative association with cumulus cell mRNA.

机构信息

University Women's Hospital, Division of Gynaecological Endocrinology and Reproductive Medicine, Inselspital, Switzerland.

出版信息

Reprod Biomed Online. 2022 Jan;44(1):193-199. doi: 10.1016/j.rbmo.2021.08.018. Epub 2021 Aug 24.

DOI:10.1016/j.rbmo.2021.08.018

PMID:34836815

Abstract

RESEARCH QUESTION

Do follicular fluid hormone concentrations and the mRNA expression of LHCG, FSH and androgen receptors, aromatase and anti-Müllerian hormone (AMH) in cumulus granulosa cells differ in naturally matured and stimulated follicles?

DESIGN

Cross-sectional study involving 57 natural cycle IVF (NC-IVF) and 36 conventional gonadotrophin-stimulated IVF (cIVF) cycles performed between 2014 and 2016. cIVF was performed by ovarian stimulation with human menopausal gonadotrophin and gonadotrophin-releasing hormone antagonists. Hormone concentrations were determined in the follicular fluid of the leading follicle, and mRNA concentrations were quantified by reverse transcription polymerase chain reaction in RNA extracted from granulosa cells of the cumulus oophorus complex obtained from these fluids.

RESULTS

Follicular fluid hormone concentrations were significantly lower in cIVF compared with NC-IVF follicles. Median concentrations were 0.50 and 14.5 mIU/ml for LH (P < 0.001), 16.1 and 46.5 nmol/l for testosterone (P < 0.001), 1270 and 2675 nmol/l for oestradiol (P < 0.001), and 12.3 and 28.9 pmol/l for AMH (P < 0.001), respectively. In cumulus granulosa cells, mRNA concentrations for LH receptor, FSH receptor, androgen receptor, aromatase and AMH did not differ between cIVF and NC-IVF follicles. Several hormone and mRNA concentrations were quantitatively associated in natural cycles such as follicular fluid AMH and cumulus granulosa cells AMH RNA (r = 0.107, P = 0.013), follicular fluid testosterone and cumulus granulosa cell AMH RNA (r = 0.158, P = 0.002), follicular fluid oestradiol and cumulus granulosa cell AMH RNA (r = 0.105, P = 0.014) and follicular fluid oestradiol and aromatase (r = 0.113, P = 0.011). In contrast, these associations were not observed in stimulated cycles.

CONCLUSION

These findings indicate some effects of gonadotrophin stimulation on follicular physiology, which could be a cause for the previously suggested lower oocyte quality in cIVF compared with NC-IVF.

摘要

研究问题

自然成熟卵泡和刺激卵泡的卵泡液激素浓度以及颗粒细胞中 LHCG、FSH 和雄激素受体、芳香化酶和抗苗勒管激素（AMH）的 mRNA 表达是否存在差异？

设计

这是一项 2014 年至 2016 年期间进行的涉及 57 例自然周期 IVF（NC-IVF）和 36 例常规促性腺激素刺激 IVF（cIVF）周期的横断面研究。cIVF 通过人绝经期促性腺激素和促性腺激素释放激素拮抗剂进行卵巢刺激。在主导卵泡的卵泡液中测定激素浓度，并通过逆转录聚合酶链反应从这些液体中获得的卵丘卵母细胞复合体的颗粒细胞中提取的 RNA 中定量 mRNA 浓度。

结果

与 NC-IVF 卵泡相比，cIVF 卵泡的卵泡液激素浓度显著降低。LH 的中位数浓度分别为 0.50 和 14.5 mIU/ml（P < 0.001），睾酮为 16.1 和 46.5 nmol/l（P < 0.001），雌二醇为 1270 和 2675 nmol/l（P < 0.001），AMH 为 12.3 和 28.9 pmol/l（P < 0.001）。在卵丘颗粒细胞中，cIVF 和 NC-IVF 卵泡之间的 LH 受体、FSH 受体、雄激素受体、芳香化酶和 AMH 的 mRNA 浓度没有差异。在自然周期中，几种激素和 mRNA 浓度存在定量关联，例如卵泡液 AMH 和卵丘颗粒细胞 AMH RNA（r = 0.107，P = 0.013）、卵泡液睾酮和卵丘颗粒细胞 AMH RNA（r = 0.158，P = 0.002）、卵泡液雌二醇和卵丘颗粒细胞 AMH RNA（r = 0.105，P = 0.014）和卵泡液雌二醇和芳香化酶（r = 0.113，P = 0.011）。相比之下，这些关联在刺激周期中没有观察到。