1
|
Recchia K, Jorge AS, Pessôa LVDF, Botigelli RC, Zugaib VC, de Souza AF, Martins DDS, Ambrósio CE, Bressan FF, Pieri NCG. Actions and Roles of FSH in Germinative Cells. Int J Mol Sci 2021; 22:10110. [PMID: 34576272 PMCID: PMC8470522 DOI: 10.3390/ijms221810110] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 12/21/2022] Open
Abstract
Follicle stimulating hormone (FSH) is produced by the pituitary gland in a coordinated hypothalamic-pituitary-gonadal (HPG) axis event, plays important roles in reproduction and germ cell development during different phases of reproductive development (fetal, neonatal, puberty, and adult life), and is consequently essential for fertility. FSH is a heterodimeric glycoprotein hormone of two dissociable subunits, α and β. The FSH β-subunit (FSHβ) function starts upon coupling to its specific receptor: follicle-stimulating hormone receptor (FSHR). FSHRs are localized mainly on the surface of target cells on the testis and ovary (granulosa and Sertoli cells) and have recently been found in testicular stem cells and extra-gonadal tissue. Several reproduction disorders are associated with absent or low FSH secretion, with mutation of the FSH β-subunit or the FSH receptor, and/or its signaling pathways. However, the influence of FSH on germ cells is still poorly understood; some studies have suggested that this hormone also plays a determinant role in the self-renewal of germinative cells and acts to increase undifferentiated spermatogonia proliferation. In addition, in vitro, together with other factors, it assists the process of differentiation of primordial germ cells (PGCLCs) into gametes (oocyte-like and SSCLCs). In this review, we describe relevant research on the influence of FSH on spermatogenesis and folliculogenesis, mainly in the germ cell of humans and other species. The possible roles of FSH in germ cell generation in vitro are also presented.
Collapse
Affiliation(s)
- Kaiana Recchia
- Department of Surgery, Faculty of Veterinary Medicine and Animal Sciences, University of São Paulo, São Paulo 01001-010, Brazil; (K.R.); (F.F.B.)
| | - Amanda Soares Jorge
- Department of Veterinary Medicine, School of Animal Sciences and Food Engineering, University of Sao Paulo, Pirassununga 13635-900, Brazil; (A.S.J.); (L.V.d.F.P.); (R.C.B.); (V.C.Z.); (D.d.S.M.); (C.E.A.)
| | - Laís Vicari de Figueiredo Pessôa
- Department of Veterinary Medicine, School of Animal Sciences and Food Engineering, University of Sao Paulo, Pirassununga 13635-900, Brazil; (A.S.J.); (L.V.d.F.P.); (R.C.B.); (V.C.Z.); (D.d.S.M.); (C.E.A.)
| | - Ramon Cesar Botigelli
- Department of Veterinary Medicine, School of Animal Sciences and Food Engineering, University of Sao Paulo, Pirassununga 13635-900, Brazil; (A.S.J.); (L.V.d.F.P.); (R.C.B.); (V.C.Z.); (D.d.S.M.); (C.E.A.)
- Department of Pharmacology, Institute of Biosciences, São Paulo State University (UNESP), Botucatu 18618-970, Brazil
| | - Vanessa Cristiane Zugaib
- Department of Veterinary Medicine, School of Animal Sciences and Food Engineering, University of Sao Paulo, Pirassununga 13635-900, Brazil; (A.S.J.); (L.V.d.F.P.); (R.C.B.); (V.C.Z.); (D.d.S.M.); (C.E.A.)
| | - Aline Fernanda de Souza
- Department Biomedical Science, Ontary Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada;
| | - Daniele dos Santos Martins
- Department of Veterinary Medicine, School of Animal Sciences and Food Engineering, University of Sao Paulo, Pirassununga 13635-900, Brazil; (A.S.J.); (L.V.d.F.P.); (R.C.B.); (V.C.Z.); (D.d.S.M.); (C.E.A.)
| | - Carlos Eduardo Ambrósio
- Department of Veterinary Medicine, School of Animal Sciences and Food Engineering, University of Sao Paulo, Pirassununga 13635-900, Brazil; (A.S.J.); (L.V.d.F.P.); (R.C.B.); (V.C.Z.); (D.d.S.M.); (C.E.A.)
| | - Fabiana Fernandes Bressan
- Department of Surgery, Faculty of Veterinary Medicine and Animal Sciences, University of São Paulo, São Paulo 01001-010, Brazil; (K.R.); (F.F.B.)
- Department of Veterinary Medicine, School of Animal Sciences and Food Engineering, University of Sao Paulo, Pirassununga 13635-900, Brazil; (A.S.J.); (L.V.d.F.P.); (R.C.B.); (V.C.Z.); (D.d.S.M.); (C.E.A.)
| | - Naira Caroline Godoy Pieri
- Department of Veterinary Medicine, School of Animal Sciences and Food Engineering, University of Sao Paulo, Pirassununga 13635-900, Brazil; (A.S.J.); (L.V.d.F.P.); (R.C.B.); (V.C.Z.); (D.d.S.M.); (C.E.A.)
| |
Collapse
|
2
|
Riestenberg C, Ahern S, Shamonki M. Follicle-stimulating hormone receptor autoantibody associated primary ovarian insufficiency successfully treated with corticosteroids: a case report. F S Rep 2021; 1:206-208. [PMID: 34223245 PMCID: PMC8244256 DOI: 10.1016/j.xfre.2020.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/23/2020] [Accepted: 09/04/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To report a case of successful controlled ovarian stimulation (COH) for oocyte cryopreservation in a patient with autoimmune primary ovarian insufficiency (POI) and polyglandular autoimmune syndrome (PGAS) type 2. DESIGN Case report. SETTING Private in vitro fertilization clinic. PATIENTS 25-Year-old woman, G0, with autoimmune POI and PGAS type 2. INTERVENTIONS Diagnosis of autoimmune interference with FSH signaling, with subsequent high-dose corticosteroid immune suppression and successful oocyte cryopreservation. MAIN OUTCOMES MEASURES Successful stimulation with exogenous gonadotropins, oocyte retrieval, and cryopreservation. RESULTS Retrieval and cryopreservation of 36 metaphase-II (MII) oocytes. CONCLUSIONS Scrutiny of POI cases will facilitate identification of a subset of patients in whom immune suppression with short-term, high-dose corticosteroids may enable successful COH.
Collapse
Affiliation(s)
- Carrie Riestenberg
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of California-Los Angeles, Los Angeles, California
| | - Susan Ahern
- Division of Endocrinology, Department of Medicine, University of California-Los Angeles, Ventura, California
| | - Mousa Shamonki
- Fertility & Surgical Associates of California, Thousand Oaks, California
| |
Collapse
|
3
|
Abnormally Elevated Follicle-Stimulating Hormone (FSH) Level in an Infertile Woman. Case Rep Endocrinol 2019; 2019:3071649. [PMID: 31662912 PMCID: PMC6778895 DOI: 10.1155/2019/3071649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 08/09/2019] [Indexed: 11/17/2022] Open
Abstract
We report a case of 33-year-old woman with a 4-year primary infertility. A high isolated follicle-stimulating hormone (FSH) level was conflicting with the clinical situation and with other hormonal markers which were in favor of polycystic ovarian syndrome. We followed a strategy used to identify immune complexes involving FSH. The PEG precipitation test revealed that the high FSH level was almost exclusively due to the presence of autoimmune FSH immunoglobulin complex (macro-FSH). The profile obtained by gel filtration chromatography confirmed the presence of an FSH-immunoglobulin complex. Such immunological dysregulation could be explored in cases of unexplained infertility and recurrent IVF failure.
Collapse
|
4
|
Kara E, Dupuy L, Bouillon C, Casteret S, Maurel MC. Modulation of Gonadotropins Activity by Antibodies. Front Endocrinol (Lausanne) 2019; 10:15. [PMID: 30833928 PMCID: PMC6387920 DOI: 10.3389/fendo.2019.00015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 01/10/2019] [Indexed: 12/19/2022] Open
Abstract
Gonadotropins are essential for reproduction control in humans as well as in animals. They are widely used all over the world for ovarian stimulation in women, spermatogenesis stimulation in men, and ovulation induction and superovulation in animals. Despite the availability of many different preparations, all are made of the native hormones. Having different ligands with a wide activity range for a given receptor helps better understand its molecular and cellular signaling mechanisms as well as its physiological functions, and thus helps the development of more specific and adapted medicines. One way to control the gonadotropins' activity could be the use of modulating antibodies. Antibodies are powerful tools that were largely used to decipher gonadotropins' actions and they have shown their utility as therapeutics in several other indications such as cancer. In this review, we summarize the inhibitory and potentiating antibodies to gonadotropins, and their potential therapeutic applications.
Collapse
Affiliation(s)
| | | | - Céline Bouillon
- Igyxos SA, Nouzilly, France
- Service de Médecine et Biologie de la Reproduction, CHRU de Tours, Tours, France
- Biologie Intégrative de l'Ovaire, INRA, UMR85, Physiologie de la Reproduction et des Comportements, Nouzilly, France
- CNRS, UMR7247, Nouzilly, France
- Université François Rabelais, Tours, France
- IFCE, Nouzilly, France
| | | | | |
Collapse
|
5
|
The effects of superovulation with gonadotropins on autoantibody levels in patients undergoing assisted reproductive cycles. Arch Gynecol Obstet 2018; 298:183-189. [PMID: 29696351 DOI: 10.1007/s00404-018-4775-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 04/03/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE To evaluate the effect of controlled ovarian stimulation (COH) with gonadotropins on the serum levels of autoantibodies in the women who underwent in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles and to compare basal levels of these autoantibodies between groups according to history of COH. METHODS This prospective cohort study was performed from October 2014 to March 2016 in the Royan Institute. The volunteered infertile women with regard to the inclusion criteria, who underwent IVF/ICSI cycles, were recruited. The COH was performed according to standard long GnRH agonist protocol. The mean levels of the autoantibodies including anti-nuclear, anti-smooth muscle, anti-ovarian, anti-mitochondrial, anti β2-glycoprotein I, anti-parietal cell and anti-follicle-stimulating hormone antibodies were measured at three time points: on the 3-5 days of the menstrual cycle, 1 week after starting of COH and the ovum pick-up (OPU) day. RESULTS Of all participants (n = 189), 73 women had history of COH (group B) and 116 women did not have such history (group A). The analysis indicated that the autoantibodies changes during COH were similar in both groups. COH has no significant impact on the level of autoantibodies during the stimulation cycle. Multiple logistic regression analysis showed that the serum levels of anti-smooth muscle antibody on OPU day was the positive predictive factors for live birth following ART cycles in the studied population. CONCLUSION No significant effect of COH on the studied autoantibodies by the time of OPU was found but further studies are required to interpret these results.
Collapse
|
6
|
Morte C, Celma C, De Geyter C, Urbancsek J, Coroleu Lletget B, Cometti B. Assessment of the immunogenicity of gonadotrophins during controlled ovarian stimulation. Am J Reprod Immunol 2017; 78. [PMID: 28378950 PMCID: PMC6084367 DOI: 10.1111/aji.12675] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/23/2017] [Indexed: 11/30/2022] Open
Abstract
Problem Gonadotrophin hormones are used for the controlled ovarian stimulation (COS) as part of the in vitro fertilization techniques. Therapeutic proteins have the potential to induce an unwanted immune response. Method of study The presence of anti‐FSH, anti‐LH and anti‐hCG antibodies were determined in patients from two different clinical trials after the repeated administration of hMG or FSH. Results In the first study, 27 subjects were screening for the presence of anti‐FSH antibodies. From the 27 patients, only one patient showed the presence of low levels of antibodies. In a second study, 25 patients were screened for the presence of anti‐FSH, anti‐LH and anti‐hCG antibodies. At the end of the study, no patients showed the presence of antibodies. Conclusion The results of this study suggest that repeated treatment cycles with FSH or hMG in patients undergoing COS for in vitro fertilization can be safely and effectively applied without concerns for immunogenicity.
Collapse
Affiliation(s)
- Carles Morte
- Kymos Pharma Services, Parc Tecnològic del Valles, Barcelona, Spain
| | - Carles Celma
- Kymos Pharma Services, Parc Tecnològic del Valles, Barcelona, Spain
| | - Christian De Geyter
- Klinik für gyn. Endokrinologie und Reproduktionsmedizin, University of Basel, Basel, Switzerland
| | - Janos Urbancsek
- Division of Assisted Reproduction, First Department of Ob/Gyn, Semmelweis University, Budapest, Hungary
| | | | | |
Collapse
|
7
|
Cocco C, Brancia C, D'Amato F, Noli B. Pituitary gonadotropins and autoimmunity. Mol Cell Endocrinol 2014; 385:97-104. [PMID: 24153235 DOI: 10.1016/j.mce.2013.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 10/08/2013] [Accepted: 10/09/2013] [Indexed: 10/26/2022]
Abstract
Autoimmune disease occurs when the body produces an inappropriate immune response against its own tissues producing antibodies, called autoantibodies, reacting to specific antigens. Studies regarding the presence of an autoimmune process specifically involving gonadotropins date from over than 20 years ago, when antibodies to gonadotropic-secreting cells were found by immunofluorescence in sera from a group of patients affected by cryptorchidism. Later on, antibodies detected by the same technique, and directed to the same cells were also found at high titer in sera from patients affected by hypogonadotropic hypogonadism, Kallmann's syndrome, lymphocytic hypophysitis with isolated gonadotropin deficiency, as well as autoimmune polyendocrine syndrome. Concerning the autoimmune target/s within the gonadotropic cells, rarely autoantibodies were found labeling gonadotropins while in a large number of cases, auto-antigens remained to be identified. Since pituitary gonadotropins are fundamental for the sexual maturity and reproductive mechanisms, patients with infertility were largely investigated by enzyme-linked immunosorbent assay for the presence of circulating antibodies likely interfering with gonadotropin activity. In infertile women, autoantibodies to gonadotropins were found related to ovarian autoimmunity, ovarian disorders that cause infertility and also associated with in vitro fertilization treatments. In infertile men, autoantibodies to gonadotropins may alter the testicular spermatogenesis and cause apoptosis of the spermatogenic cells. In conclusion, circulating antibodies were found labeling gonadotropic cells and/or gonadotropins, and in both cases they could create dysfunctions in gonadotropin related mechanism. The intriguing question of what can cause the production of such autoantibodies is not clear yet.
Collapse
Affiliation(s)
- Cristina Cocco
- NEF-Laboratory, Department of Biomedical Science, University of Cagliari, 09042 Monserrato, Cagliari, Italy.
| | - Carla Brancia
- NEF-Laboratory, Department of Biomedical Science, University of Cagliari, 09042 Monserrato, Cagliari, Italy
| | - Filomena D'Amato
- NEF-Laboratory, Department of Biomedical Science, University of Cagliari, 09042 Monserrato, Cagliari, Italy
| | - Barbara Noli
- NEF-Laboratory, Department of Biomedical Science, University of Cagliari, 09042 Monserrato, Cagliari, Italy
| |
Collapse
|
8
|
The possible role of genetic variants in autoimmune-related genes in the development of endometriosis. Hum Immunol 2012; 73:306-15. [DOI: 10.1016/j.humimm.2011.12.009] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Revised: 11/21/2011] [Accepted: 12/06/2011] [Indexed: 11/18/2022]
|
9
|
Haller-Kikkatalo K, Sarapik A, Faure GC, Béné MC, Massin F, Salumets A, Uibo R. Serum sTREM-1 (soluble triggering receptor expressed on myeloid cells-1) associates negatively with embryo quality in infertility patients. Am J Reprod Immunol 2012; 68:68-74. [PMID: 22229451 DOI: 10.1111/j.1600-0897.2011.01102.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 12/13/2011] [Indexed: 12/25/2022] Open
Abstract
PROBLEM Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) is a useful biomarker of infection and inflammation. METHOD OF STUDY We studied serum and follicular fluid sTREM-1 in infertile patients (N = 110) utilizing enzyme-linked immunosorbent assay. RESULTS Serum and follicular sTREM-1 were in good correlation (Pearson's correlation 0.56, P < 0.0001) with higher values in follicular fluid (140.4 ± 34.4 and 115.6 ± 35.1 pg/mL, t-test, P < 0.0001). Endometriosis associated with lower follicular and serum sTREM-1 compared with male factor infertility patients (age-adjusted r = -25.7 pg/mL, P = 0.018; r = -22.1 pg/mL, P = 0.030). No associations between follicular or serum sTREM-1 and clinical parameters were found, except higher serum sTREM-1 associated with lower embryo quality in all patients (adjusted r = -0.3%, P = 0.033), with a cutoff value between 111.5 and 113.3 pg/mL (OR = 0.38, P = 0.048; OR = 0.34, P = 0.028) predicting that more than 39% of embryos would be with good quality. CONCLUSION Serum sTREM-1 could represent a prognostic marker for female fecundity, probably indicating impaired inflammatory reaction of immune system.
Collapse
Affiliation(s)
- Kadri Haller-Kikkatalo
- Immunology Group, Institute of General and Molecular Pathology, University of Tartu, Tartu, Estonia.
| | | | | | | | | | | | | |
Collapse
|
10
|
Review on autoimmune reactions in female infertility: antibodies to follicle stimulating hormone. Clin Dev Immunol 2011; 2012:762541. [PMID: 22007255 PMCID: PMC3189473 DOI: 10.1155/2012/762541] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Accepted: 08/03/2011] [Indexed: 01/16/2023]
Abstract
Female fertility can be affected by diseases or dysfunctions of reproductive tract, neuroendocrine system, and immune system. Reproductive autoimmune failure can be associated with overall activation of immune system or with immune system reactions specifically directed against ovarian antigens. Majority of the antiovarian autoantibodies are directed against β-subunit of follicle stimulating hormone (anti-FSH). This paper summarizes a current clinical classification of female infertility in the context of general activation of autoimmunity and antiovarian autoimmunity by describing serum anti-FSH. The presence of naturally occurring anti-FSH in healthy women will be discussed. In addition, the putative impairment of ovarian folliculogenesis in case of increased production of those antibodies in infertile women will be characterized.
Collapse
|
11
|
Sarapik A, Velthut A, Haller-Kikkatalo K, Faure GC, Béné MC, de Carvalho Bittencourt M, Massin F, Uibo R, Salumets A. Follicular proinflammatory cytokines and chemokines as markers of IVF success. Clin Dev Immunol 2011; 2012:606459. [PMID: 22007253 PMCID: PMC3189459 DOI: 10.1155/2012/606459] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Accepted: 08/04/2011] [Indexed: 11/17/2022]
Abstract
Cytokines are key modulators of the immune system and also contribute to regulation of the ovarian cycle. In this study, Bender MedSystems FlowCytomix technology was used to analyze follicular cytokines (proinflammatory: IL-1β, IL-6, IL-18, IFN-γ, IFN-α, TNF-α, IL-12, and IL-23;, and anti-inflammatory: G-CSF), chemokines (MIP-1α, MIP-1β, MCP-1, RANTES, and IL-8), and other biomarkers (sAPO-1/Fas, CD44(v6)) in 153 women undergoing in vitro fertilization (IVF). Cytokine origin was studied by mRNA analysis of granulosa cells. Higher follicular MIP-1α and CD44(v6) were found to correlate with polycystic ovary syndrome, IL-23, INF-γ, and TNF-α with endometriosis, higher CD44(v6) but lower IL-β and INF-α correlated with tubal factor infertility, and lower levels of IL-18 and CD44(v6) characterized unexplained infertility. IL-12 positively correlated with oocyte fertilization and embryo development, while increased IL-18, IL-8, and MIP-1β were associated with successful IVF-induced pregnancy.
Collapse
Affiliation(s)
- Aili Sarapik
- Department of Immunology, Institute of General and Molecular Pathology, University of Tartu, Ravila 19, Tartu 50411, Estonia
| | - Agne Velthut
- Institute of Gene Technology, Tallinn University of Technology, Akadeemia Street 15, Tallinn 12618, Estonia
- Competence Centre on Reproductive Medicine and Biology, Tiigi 61b, Tartu 50410, Estonia
| | - Kadri Haller-Kikkatalo
- Department of Immunology, Institute of General and Molecular Pathology, University of Tartu, Ravila 19, Tartu 50411, Estonia
- Competence Centre on Reproductive Medicine and Biology, Tiigi 61b, Tartu 50410, Estonia
- Department of Obstetrics and Gynecology, University of Tartu, L. Puusepa 8, 51014 Tartu, Estonia
- Women's Clinic, Tartu University Hospital, L. Puusepa Street 1a, 50406 Tartu, Estonia
| | - Gilbert C. Faure
- Laboratoire d'Immunologie, Université Henri Poincaré, BP 184, Vandoeuvre lès Nancy, 54500 Nancy, France
| | - Marie-Christine Béné
- Laboratoire d'Immunologie, Université Henri Poincaré, BP 184, Vandoeuvre lès Nancy, 54500 Nancy, France
| | | | - Frédéric Massin
- Laboratoire d'Immunologie, Université Henri Poincaré, BP 184, Vandoeuvre lès Nancy, 54500 Nancy, France
| | - Raivo Uibo
- Department of Immunology, Institute of General and Molecular Pathology, University of Tartu, Ravila 19, Tartu 50411, Estonia
- Competence Centre on Reproductive Medicine and Biology, Tiigi 61b, Tartu 50410, Estonia
| | - Andres Salumets
- Competence Centre on Reproductive Medicine and Biology, Tiigi 61b, Tartu 50410, Estonia
- Department of Obstetrics and Gynecology, University of Tartu, L. Puusepa 8, 51014 Tartu, Estonia
| |
Collapse
|
12
|
Norman RJ, Zegers-Hochschild F, Salle BS, Elbers J, Heijnen E, Marintcheva-Petrova M, Mannaerts B. Repeated ovarian stimulation with corifollitropin alfa in patients in a GnRH antagonist protocol: no concern for immunogenicity. Hum Reprod 2011; 26:2200-8. [PMID: 21622693 PMCID: PMC3137390 DOI: 10.1093/humrep/der163] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND One injection of corifollitropin alfa replaces the first seven daily FSH injections in controlled ovarian stimulation (COS) cycles. Repeated treatment with therapeutic proteins may cause immune responses or hypersensitivity reactions. We assessed the immunogenicity and safety of corifollitropin alfa treatment in up to three COS cycles. METHODS In this multicentre, phase III uncontrolled trial, patients (>60 kg) started treatment with one injection of 150 µg corifollitropin alfa on cycle Day 2 or 3 of menses and 0.25 mg ganielix on stimulation Day 5 or 6. Primary outcome measures were antibody formation against corifollitropin alfa (using highly sensitive radioimmunoprecipitation assay), hypersensitivity reactions, local tolerance and adverse events (AEs). RESULTS First, second and third COS cycles were started by 682, 375 and 198 patients, respectively. No clinically relevant immunogenicity or drug-related hypersensitivity was observed. For 192 patients undergoing their third cycle a post-treatment blood sample was negative in the anti-corifollitropin antibody assay, resulting in an upper limit of the one-sided 95% confidence interval (CI) of 1.5%. Most frequent AEs were procedural pain (17.7%, 95% CI: 14.9–20.8%), headache (9.1%, 95% CI: 7.0–11.5%) and pelvic pain (7.6%, 95% CI: 5.7–9.9%). Cumulative ongoing pregnancy rate after three cycles, including frozen-thawed embryo transfer cycles and spontaneous pregnancies, was 61% (95% CI: 56–65%) after censoring for patients who discontinued. CONCLUSIONS Treatment with corifollitropin alfa can safely and effectively initiate and sustain ovarian stimulation during the first 7 days of COS in normal responder patients undergoing up to three treatment cycles, without concerns of immunogenicity. The trial was registered under ClinicalTrials.gov identifier NCT00696878.
Collapse
|
13
|
Sarapik A, Haller-Kikkatalo K, Utt M, Teesalu K, Salumets A, Uibo R. Serum anti-endometrial antibodies in infertile women - potential risk factor for implantation failure. Am J Reprod Immunol 2010; 63:349-57. [PMID: 20132165 DOI: 10.1111/j.1600-0897.2010.00808.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PROBLEM Female infertility patients with diverse etiologies show increased production of autoantibodies. METHOD OF STUDY Immunoblot analysis of sera from patients with endometriosis and tubal factor infertility (TFI) and mass spectrometry identification of candidate antigens. RESULTS The immunoblot results demonstrated the presence of IgA and IgG anti-endometrial antibodies (AEA) to various antigens at molecular weights ranging from 10 to 200 kDa. Differences were detected in certain AEA reactions between the patients' groups and particular AEA were associated with in vitro fertilization (IVF) implantation failure. IgA AEA to a 47-kDa protein were more prevalent in TFI patients and were associated with unsuccessful IVF treatment. This antigen was subsequently identified as alpha-enolase. CONCLUSION Determination of the presence and spectra of AEA in patients with endometriosis and TFI undergoing IVF may be a useful marker to predict their pregnancy outcome.
Collapse
Affiliation(s)
- Aili Sarapik
- Department of Immunology, Institute of General and Molecular Pathology, University of Tartu, Biomedicum, Estonia
| | | | | | | | | | | |
Collapse
|
14
|
Viudes De Castro M, Cortell C, Mocé E, Marco-Jiménez F, Joly T, Vicente J. Effect of recombinant gonadotropins on embryo quality in superovulated rabbit does and immune response after repeated treatments. Theriogenology 2009; 72:655-62. [DOI: 10.1016/j.theriogenology.2009.04.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2009] [Revised: 04/17/2009] [Accepted: 04/21/2009] [Indexed: 11/29/2022]
|
15
|
Haller K, Sikut A, Karro H, Uibo R, Salumets A. Circulating anti-follicle-stimulating hormone immunoglobulin A in women: a sperm-prone reaction of mucosal tolerance? Fertil Steril 2008; 90:1253-5. [DOI: 10.1016/j.fertnstert.2007.08.073] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2007] [Revised: 08/23/2007] [Accepted: 08/31/2007] [Indexed: 11/28/2022]
|
16
|
Haller K, Salumets A, Uibo R. Anti-FSH antibodies associate with poor outcome of ovarian stimulation in IVF. Reprod Biomed Online 2008; 16:350-5. [DOI: 10.1016/s1472-6483(10)60595-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
17
|
Altmäe S, Haller K, Peters M, Hovatta O, Stavreus-Evers A, Karro H, Metspalu A, Salumets A. Allelic estrogen receptor 1 (ESR1) gene variants predict the outcome of ovarian stimulation in in vitro fertilization. Mol Hum Reprod 2007; 13:521-6. [PMID: 17540666 DOI: 10.1093/molehr/gam035] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The outcome of in vitro fertilization (IVF) depends substantially on the effectiveness of controlled ovarian hyperstimulation (COH) induced by administration of follicle-stimulating hormone (FSH). In COH, endogenously produced estrogens extend the action of FSH in stimulating folliculogenesis. We determined the associations between genetic variations in estrogen receptor ESR1 and ESR2 genes and etiology of female infertility, and analysed the influence of these variations on COH outcome-the quantity and quality of oocytes retrieved. ESR1 PvuII T/C (rs2234693) and XbaI A/G (rs9340799) single-nucleotide polymorphisms (SNPs) and (TA)n microsatellite polymorphism, as well as ESR2 RsaI G/A (rs1256049) SNP and (CA)n microsatellite polymorphism were genotyped in 159 IVF patients. The ovarian response to FSH was diminished in patients with endometriosis when compared to tubal factor infertility. ESR1 PvuII and XbaI as well as ESR2 RsaI SNPs were associated with the microsatellite length of the respective genes. Shorter ESR1 (TA)n was linked with a higher risk for unexplained infertility, whereas longer ESR1 (TA)n associated with PvuII*C allele were predictive of a better COH, but not clinical pregnancy outcome in an age-independent manner. These data suggest the variations in ESR1 gene, in addition to the age of a woman, may predict the COH outcome in IVF.
Collapse
Affiliation(s)
- Signe Altmäe
- Department of Biotechnology, Institute of Molecular and Cell Biology, Estonian Genome Project, University of Tartu, Estonia, and Department of Clinical Science, Intervention and Technology, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | | | | | | | | | | | | | | |
Collapse
|