The Urological Surgical Department, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
The Reproductive Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China, No. 96, Fuxue Road, Lucheng District.
J Ovarian Res. 2023 Sep 11;16(1):189. doi: 10.1186/s13048-023-01271-6.
The concentration of human chorionic gonadotropin (hCG)/ luteinizing hormone (LH) after triggering is generally accepted as a predictor of the normal ovarian response to the trigger, but few studies have explored the distribution model of concentration and its impact on oocyte yield. Genetic variations in LHCGR, known as a receptor for hCG and LH, also play a role in oocyte maturation and retrieval. The objective of the study was to investigate the impact of concentrations of hCG/LH after triggering on oocyte yield and its association with genetic variants of LHCGR.
A retrospective cohort study including 372 antagonist IVF cycles, in which 205 received the recombinant hCG trigger and 167 received the gonadotropin-releasing hormone agonist (GnRH-a) trigger, was conducted. The post-trigger concentrations of hCG/LH and the LHCGR N312S (rs2293275) genotype were evaluated in patients to analyse the impact of these factors on oocyte yield.
The oocyte retrieval rate (ORR) increased significantly among the low-, medium- and high-hCG-concentration groups (0.91 ± 0.25, 0.99 ± 0.23 and 1.08 ± 0.19, P < 0.001) and among the low-, medium- and high-LH-concentration groups (0.80 ± 0.29, 0.95 ± 0.21 and 1.07 ± 0.19, P < 0.001). The Pearson correlation coefficient between the post-trigger hCG concentration and ORR was 0.242 (P < 0.001), and that between the LH concentration and ORR was 0.454 (P < 0.001). After adjustment for confounding factors, high post-trigger LH concentrations remained associated with the significantly higher ORRs (adjusted R = 0.541, P < 0.001). Patients with the AG genotype of LHCGR N312S were more likely to have low post-trigger LH concentrations (46.10 IU/L versus 60.91 IU/L, P < 0.001) and a significantly lower ORR (0.85 versus 0.96, P = 0.042) than patients with the GG genotype after the GnRH-a trigger.
The post-trigger LH concentration can positively predict oocyte yield in antagonist IVF cycles, and patients with the AG genotype of LHCGR rs2293275 could have a suboptimal oocyte yield using the GnRH-a trigger.
人绒毛膜促性腺激素（hCG）/促黄体生成激素（LH）在触发后的浓度通常被认为是预测卵巢对触发反应正常的指标，但很少有研究探讨其浓度的分布模式及其对卵母细胞产量的影响。LHCGR 的基因变异，即 hCG 和 LH 的受体，也在卵母细胞成熟和回收中发挥作用。本研究旨在探讨触发后 hCG/LH 浓度对卵母细胞产量的影响及其与 LHCGR 基因变异的关系。
对 372 例拮抗剂 IVF 周期进行回顾性队列研究，其中 205 例接受重组 hCG 触发，167 例接受促性腺激素释放激素激动剂（GnRH-a）触发。评估患者触发后 hCG/LH 浓度和 LHCGR N312S（rs2293275）基因型，分析这些因素对卵母细胞产量的影响。
低、中、高 hCG 浓度组的卵母细胞回收率（ORR）均显著升高（0.91±0.25、0.99±0.23 和 1.08±0.19，P<0.001），低、中、高 LH 浓度组的 ORR 也均显著升高（0.80±0.29、0.95±0.21 和 1.07±0.19，P<0.001）。触发后 hCG 浓度与 ORR 的 Pearson 相关系数为 0.242（P<0.001），LH 浓度与 ORR 的 Pearson 相关系数为 0.454（P<0.001）。调整混杂因素后，高触发后 LH 浓度仍与显著较高的 ORR 相关（调整 R=0.541，P<0.001）。LHCGR N312S 的 AG 基因型患者触发后 LH 浓度较低（46.10 IU/L 与 60.91 IU/L，P<0.001），ORR 明显较低（0.85 与 0.96，P=0.042），低于 GG 基因型患者。
拮抗剂 IVF 周期中，触发后 LH 浓度可正向预测卵母细胞产量，LHCGR rs2293275 的 AG 基因型患者使用 GnRH-a 触发可能卵母细胞产量不佳。
