title: Follicular fluid hormonal profile and cumulus cell gene expression in controlled ovarian hyperstimulation with recombinant FSH: effects of recombinant LH administration.
abstract: OBJECTIVE
  Down-regulation with gonadodropin-releasing agonist (GnRH-a) protocol during IVF stimulation leads to a severe endogenous LH suppression, which may affect the follicular development. The aim of the study was to evaluate the effects of recombinant LH (r-LH) administration, during late follicular development stages, in recombinant FSH (r-FSH) stimulated cycles on follicular fluid (FF) parameters and on cumulus cell quality.
  
  
  METHODS
  Twenty patients undergoing IVF were stimulated in a long GnRH agonist protocol with r-FSH alone or with r-LH supplementation when the leading follicle reached diameter of 14 mm. FF was collected at the time of oocyte retrieval from 32 follicles ≥ 18 mm. Serum FSH, LH, estradiol (E(2)), and progesterone (P(4)) were evaluated on the day of hCG administration. Intra-follicular E(2), P(4), AMH and TGF-β were assayed. Total RNA from 18 individual cumuli was isolated for gene expression analyses.
  
  
  RESULTS
  R-LH increased FF P(4) levels. FF TGF-β levels and PTGS2 and HAS2 expression in cumulus cells (CCs) positively correlated with increased P(4) levels observed in FFs, while a negative correlation was found between P(4) and AMH levels.
  
  
  CONCLUSIONS
  FF positive correlation between P(4) and TGF-β levels and CC expression of PTGS2 and HAS2 suggest an association with a better follicle quality. In addition, our data suggest that late follicular phase r-LH supplementation leads to a more advanced stage of follicular maturation.
authors.affiliation: Department of Anatomy, Histology, Forensic Medicine and Orthopedic, Section of Histology, Sapienza University of Rome, Rome, Italy.
authors.forename: Marzia
authors.initials: M
authors.lastname: Barberi
authors.forename: Beatrice
authors.initials: B
authors.lastname: Ermini
authors.forename: Maria Beatrice
authors.initials: MB
authors.lastname: Morelli
authors.forename: Michele
authors.initials: M
authors.lastname: Ermini
authors.forename: Sandra
authors.initials: S
authors.lastname: Cecconi
authors.forename: Rita
authors.initials: R
authors.lastname: Canipari
mesh_terms: D054885:Cumulus Cells / Q000166:cytology / Q000187:drug effects / Q000378:metabolism; D015536:Down-Regulation; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage* / Q000097:blood / Q000235:genetics; D015571:Follicular Fluid / Q000187:drug effects / Q000378:metabolism; D018507:Gene Expression Regulation, Developmental / Q000187:drug effects; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage* / Q000037:antagonists & inhibitors / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000008:administration & dosage / Q000097:blood / Q000235:genetics; D009865:Oocytes / Q000166:cytology / Q000187:drug effects; D006080:Ovarian Follicle / Q000166:cytology / Q000378:metabolism; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D011374:Progesterone / Q000008:administration & dosage / Q000097:blood; D011994:Recombinant Proteins / Q000008:administration & dosage
chemical_list: D011994:Recombinant Proteins; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone