Leuprolide acetate reduces both in vivo and in vitro ovarian steroidogenesis in infertile women undergoing assisted reproduction

A Flexible Multidose GnRH Antagonist versus a Microdose Flare-Up GnRH Agonist Combined with a Flexible Multidose GnRH Antagonist Protocol in Poor Responders to IVF

Objective. To compare the effectiveness of a flexible multidose gonadotropin-releasing hormone (GnRH) antagonist against the effectiveness of a microdose flare-up GnRH agonist combined with a flexible multidose GnRH antagonist protocol in poor responders to in vitro fertilization (IVF). Study Design. A retrospective study in Akdeniz University, Faculty of Medicine, Department of Obstetrics and Gynecology, IVF Center, for 131 poor responders in the intracytoplasmic sperm injection-embryo transfer (ICSI-ET) program between January 2006 and November 2012. The groups were compared to the patients' characteristics, controlled ovarian stimulation (COH) results, and laboratory results. Results. Combination protocol was applied to 46 patients (group 1), and a single protocol was applied to 85 patients (group 2). In group 1, the duration of the treatment was longer and the dose of FSH was higher. The cycle cancellation rate was significantly higher in group 2 (26.1% versus 38.8%). A significant difference was not observed with respect to the number and quality of oocytes and embryos or to the number of embryos transferred. There were no statistically significant differences in the hCG positivity (9.5% versus 9.4%) or the clinical pregnancy rates (7.1% versus 10.6%). Conclusion. The combination protocol does not provide additional efficacy.

Endometriosis does not Alter Aromatase Gene Expression (CYP19A1) in Mural Lutein-granulosa Cells of Women Undergoing Assisted Reproduction Techniques – a Pilot Study

Purpose

The aim of this study was to quantify aromatase gene expression in mural lutein-granulosa cells of women with endometriosis undergoing assisted reproduction techniques (ART, IVF or ICSI). Methods: a case-control study was performed on 11 women with endometriosis (all stages, ASRM criteria) and 11 women with male or tubal causes of infertility undergoing ART. There was no difference between the groups regarding age, amount of gonadotrophins used, days of induction, follicles, and eggs collected. Mural lutein-granulosa cells were harvested from pre-ovulatory follicles during oocyte retrieval and correctly isolated. After cells lyses and storage into Trizol LS Reagent®, RNA extraction and cDNA synthesis were performed. Quantification of relative gene expression for CYP19A1 (aromatase) was performed by real time PCR, using SYBR Green reagents. All experiments were performed in duplicates.

Results

there was no difference between the groups in the quantitative gene expression of CYP19A1 (aromatase) gene on mural lutein-granulosa cells (P>.05, Mann Whitney).

Conclusions

These results suggest that this enzyme, aromatase, may have a complex and refined control of its gene expression on this population of granulosa cells, and in spite of previous evidence showing its reduced activity on these cells in endometriosis, gene expression per se may not be affected by the disease.