title: Impact of final oocyte maturation using gonadotropin-releasing hormone agonist triggering and different luteal support protocols on endometrial gene expression.
abstract: OBJECTIVE
  To use microarray technology to analyze endometrial gene expression after gonadotropin-releasing hormone agonist (GnRH-a) triggering with four different protocols of luteal support in comparison with results obtained after a human chorionic gonadotropin (hCG) trigger.
  
  
  METHODS
  Prospective, randomized, controlled trial.
  
  
  METHODS
  University-affiliated private assisted-reproduction center.
  
  
  METHODS
  25 healthy oocyte donors undergoing controlled ovarian stimulation.
  
  
  METHODS
  On day of final oocyte maturation, randomization to [1] GnRH-agonist triggering and luteal support with oral estradiol (2 mg/8 hours) and vaginal progesterone (200 mg/12 hours), [2] GnRH-a and a daily dose of 150 IU of recombinant LH from oocyte pickup, [3] GnRH-a and a single bolus of 60 μg of recombinant hCG on oocyte pickup, [4] GnRH-a and three doses of 20 μg of recombinant hCG separated by 48 hours, or [5] 250 μg of recombinant hCG for trigger and standard luteal support; with endometrial biopsy samples collected 7 days after triggering.
  
  
  METHODS
  Gene expression using the Endometrial Receptivity Array (ERA) and pathway and network analysis of study groups 1-4 compared with controls (group 5).
  
  
  RESULTS
  The 56 genes in group 1 (25 up-regulated and 31 down-regulated) exhibited altered expression compared with the 36 genes from group 2 (13 up-regulated and 23 down-regulated), 44 from group 3 (28 up-regulated and 16 down-regulated), and 30 (20 up-regulated and 10 down-regulated) from group 4.
  
  
  CONCLUSIONS
  Differences were seen in endometrial gene expression related to the type of ovulation trigger and luteal support. However, gene expression after the GnRH-a trigger and modified luteal support adding LH/hCG activity more closely resembles the pattern seen in the hCG group.
  
  
  BACKGROUND
  EudraCT 2011-003250-34.
authors.affiliation: IVI Madrid, Madrid, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Bermejo
authors.affiliation: IVI Madrid, Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Cerrillo
authors.affiliation: IVIOMICS SL, Paterna, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Ruiz-Alonso
authors.affiliation: Fundación IVI, Valencia University INCLIVA, Valencia, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Blesa
authors.affiliation: Fundación IVI, Valencia University INCLIVA, Valencia, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Simón
authors.affiliation: IVI Valencia, Valencia University, Valencia, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pellicer
authors.affiliation: IVI Madrid, Madrid, Spain; Rey Juan Carlos University, Madrid, Spain. Electronic address: juan.garcia.velasco@ivi.es.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Garcia-Velasco
mesh_terms: D000293:Adolescent; D000328:Adult; D004717:Endometrium / Q000187:drug effects / Q000378:metabolism*; D004958:Estradiol / Q000494:pharmacology; D005260:Female; D005786:Gene Expression Regulation; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D008183:Luteal Phase / Q000187:drug effects / Q000235:genetics* / Q000378:metabolism*; D009865:Oocytes / Q000187:drug effects / Q000378:metabolism*; D010062:Ovulation Induction / Q000379:methods; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol
keywords: Endometrial receptivity; GnRH agonist; gene expression; ovarian stimulation