Correlations between steroids concentration in follicular fluid, pronuclear morphology and embryo qualities in in vitro fertilization

The estrogen receptor polymorphisms and controlled ovulation hyperstimulation outcomes: a meta-analysis

Objective: Several studies evaluated the relationship between estrogen receptor (ER) polymorphisms and the outcomes of controlled ovulation hyperstimulation (COH). However, the results remained obscure. The objective of this study was to perform a meta-analysis to investigate the links between ER polymorphisms and COH outcomes.Methods: Eligible studies were identified from the following electronic databases: PubMed, Embase and the Chinese CNKI till Nov. 2021. The odds ratio (OR) and 95% confidence intervals (CIs) for dichotomous data and the weighted mean difference (WMD) with 95% confidence intervals (CIs) for continuous variables were used to calculate correlations between ER polymorphisms and COH outcomes. Based on the inclusion and exclusion criteria, a total of thirteen papers were eventually enrolled in the current meta-analysis.Results: The following were the key findings of this meta-analysis: (1) PvuII polymorphism had a significant relationship with IVF pregnancy outcome in all models, except the recessive model(CC VS TT: OR, 5.51, 95% CI, 1.13,26.84; CC + CT VS TT: OR, 3.73, 95% CI, 1.21,11.57; CT VS TT: OR, 3.19, 95% CI, 1.11,9.16;C VS T: OR, 2.19, 95% CI, 1.15, 4.19), with large or extreme heterogeneity; (2) XbaI polymorphism had a significant association with IVF risk in heterozygous and dominant models(AG VS GG: OR, 0.27, 95% CI, 0.12,0.61; AAAG VS GG: OR, 0.27, 95% CI, 0.12,0.59), with no heterogeneity; (3) (TA)n polymorphism was linked with IVF risk in the homozygous and recessive models(LL VS SS:OR = 3.74, 95%CI = 1.53,9.12;LL VS LS + SS:OR = 2.75, 95%CI = 1.18, 6.38), with no heterogeneity; (4) for Alul polymorphism and its association with POR risk, significant relationship was observed in the recessive model(AA VS AG + GG:OR = 2.27, 95%CI = 1.46, 3.54), with no heterogeneity;(5) PvuII T/C mutation did not predict the follicle number, oocyte number, ratio of follicles to oocytes and the risk of IVF;(6) for XbaI polymorphism and pregnancy outcome of IVF, no significant association was observed under all models; and (7) RsaI polymorphism does not increase the risk of POR under all models.Conclusion: In summary, our meta-analysis found evidence supporting that PvuII polymorphism may serve as a marker in predicting pregnancy rate in IVF-ET, XbaI and (TA)n polymorphisms may be related with infertility, and Alul polymorphism may predict the poor ovarian response to COH. More well-designed investigations are warranted to corroborate these findings.

Estradiol Regulates mRNA Levels of Estrogen Receptor Beta 4 and Beta 5 Isoforms and Modulates Human Granulosa Cell Apoptosis

Estrogen receptor beta (ERβ) plays a critical role in granulosa cell (GC) functions. The existence of four human ERβ splice isoforms in the ovary suggests their differential implication in 17β-estradiol (E2) actions on GC apoptosis causing follicular atresia. In this study, we investigated whether E2 can regulate ERβ isoforms expression to fine tune its apoptotic activities in human GC. For this purpose, we measured by RT-qPCR the expression of ERβ isoforms in primary culture of human granulosa cells (hGCs) collected from patients undergoing in vitro fertilization, before and after E2 exposure. Besides, we assessed the potential role of ERβ isoforms on cell growth and apoptosis after their overexpression in a human GC line (HGrC1 cells). We confirmed that ERβ1, ERβ2, ERβ4, and ERβ5 isoform mRNAs were predominant over that of ERα in hGCs, and found that E2 selectively regulates mRNA levels of ERβ4 and ERβ5 isoforms in these cells. In addition, we demonstrated that overexpression of ERβ1 and ERβ4 in HGrC1 cells increased cell apoptosis by 225% while ERβ5 or ERβ2 had no effect. Altogether, our study revealed that E2 may influence GC fate by specifically regulating the relative abundance of ERβ isoforms mRNA to modulate the balance between pro-apoptotic and non-apoptotic ERβ isoforms.

Association between follicular fluid levels of HMGB1 protein and outcomes in patients undergoing in vitro fertilization/intracytoplasmic sperm injection cycles

The aim of the present study was to evaluate the association between follicular fluid (FF) levels of high-mobility group box 1 (HMGB1) protein and the reproductive outcome in patients undergoing in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). FF samples were collected from the ovarian follicles (≥14 mm) of 143 infertile patients that had undergone IVF/ICSI, and the HMGB1 expression levels were determined using ELISA. Spearman's correlation and receiver operating characteristic (ROC) curve analysis were applied to analyze the results. Significantly increased levels of HMGB1 protein (7.38±2.02 vs. 6.14±2.52 ng/ml; P<0.01), endometrial thickness on the day of human chorionic gonadotropin (hCG) administration (10.3±1.3 vs. 9.7±1.7 mm; P<0.01) and retrieved oocyte counts (11.68±6.51 vs. 11.00±6.34; P<0.01) were observed in the pregnant group when compared with the non-pregnant group. Conversely, the level of luteinizing hormone on the day of hCG administration was significantly reduced in the pregnant group compared with the non-pregnant group (0.92±1.78 vs. 1.78±2.03 pmol/l, P<0.01). The ROC curve indicated a significant association between the FF level of HMGB1 protein and the pregnancy rate, with an area under the ROC curve of 0.673 (0.581-0.765; P<0.01). In addition, the HMGB1 protein level was shown to have a significant positive correlation with the endometrial thickness (r=0.170; P<0.05). Therefore, the present study indicated that the FF levels of HMGB1 protein are increased in pregnant patients and are positively correlated with endometrial thickness. Thus, FF levels of HMGB1 may be a useful factor for predicting the outcome of IVF/ICSI treatments.

Serum steroids concentration might be used for monitoring the growth of follicles in friendly in vitro fertilization

Background:  Steroid levels have been used as the predictive parameters for oocyte maturation and embryo development. In the present study, estradiol and progesterone concentrations in the follicular fluid and serum were evaluated in conventional in vitro fertilization (IVF; follicle stimulating hormone [FSH] and/or human menopausal gonadotropin [hMG] after pituitary desensitization) and friendly IVF (no stimulation, clomiphene citrate, small dose of FSH or hMG without pituitary desensitization). The purpose of the present study was to evaluate the differences in steroid distribution between conventional and friendly IVF. Methods:  Concentrations of estradiol, progesterone, FSH, and luteinizing hormone (LH) in serum and follicular fluid were determined in conventional and friendly IVF protocols by an enzyme-linked immunosorbent assay kit. Correlations between follicular fluid and serum steroid concentrations in these different protocols, and between pregnant cycles and steroid concentrations were evaluated. Results:  Two hundred and thirty-four samples of follicular fluid from 74 IVF patients were analyzed. In conventional IVF, there was no relationship in steroid levels in between follicular fluid and serum steroids, whereas serum steroid concentrations correlated with the number of developing follicles. There was a relationship between the serum and follicular fluid estradiol levels (r = 0.467, P < 0.0001) as well as progesterone levels (r = 0.227, P = 0.0488) from friendly IVF patients. Conclusions:  Serum steroid concentrations were mainly associated with the number of developing follicles. In the cases of friendly IVF, which had a small number of developing follicles, serum steroids might be used to monitor follicular fluid steroid concentrations. (Reprod Med Biol 2006; 5: 277-282).

Localization and gene expression of steroid sulfatase by RT-PCR in cumulus cells and relationship to serum FSH levels observed during in vitro fertilization

Background

The purpose of this study was to localize the expression of steroid sulfatase (STS) in cumulus cells and to determine the relationship between STS mRNA expression and the serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol and progesterone.

Methods

The subject group included 49 women (29 to 44 years old) for whom in vitro fertilization treatment was indicated. All subjects gave informed consent. One hundred fourteen samples of cumulus-oocyte complex (COC) were obtained under microscopic observation. Part of the COC was stained by STS antibody. RNA was extracted by phenol-chloroform method and real-time PCR was performed. Serum of each patient was collected and was measured by ELISA.

Results

Some of the cumulus samples were stained by STS antibody. The expression of STS mRNA in all samples was confirmed by quantitative RT-PCR. Although there was no significant correlation between the level of STS mRNA and the serum levels of estradiol, progesterone and LH, there was a statistically significant negative correlation between the level of STS mRNA expression and the serum level of FSH (n = 105, p = 0.018, r = -0.22).

Conclusion

These results have demonstrated for the first time the expression of STS in cumulus cells by immunohistological stainings and real-time RT-PCR. STS expression in cumulus cells may be related to the control of the local steroidal environment in the oocyte. Serum FSH may control STS mRNA expression from the results of RT-PCR, although the correlation was low.

Reduction of progesterone receptor expression in human cumulus cells at the time of oocyte collection during IVF is associated with good embryo quality

BACKGROUND

It has been reported that the progesterone receptor (PR) level is transiently increased within the follicle by LH stimulation and controls cumulus cells in follicles and oocyte maturation. The purpose of this study was to predict developmental competence of human oocytes during IVF via analysis of PR in cumulus cells surrounding mature oocytes.

METHODS

Prior to oocyte retrieval, the follicular diameter was measured and follicular fluid was collected from each mature follicle. Cumulus cells were manually separated from the oocyte-cumulus complex under a microscope. PR and PR mRNA were assessed by immunohistochemistry and real-time quantitative polymerase chain reaction (RT-PCR) measurement in human cumulus cells.

RESULTS

Immunoreactive PR-A was mainly localized in the cytoplasm and PR-B was localized in the nuclei. There was no significant relationship between PR expression and follicular diameter, follicular fluid concentration of steroids, or LH. There was no significant relationship between expression of PRs and fertilization or cleavage rate. However, PR expression was lower in the good morphology group (blastomeres > or =7 cells with fragmentation > or =5% on day 3) when compared to the other groups (P<0.05).

CONCLUSIONS

These results suggest that follicular LH or steroids do not affect PR expression, and full reduction of total PR expression on cumulus cells at the time of oocyte collection is associated with good morphology in human oocytes.