Abstract
Background: This study was performed to evaluate the role of luteinizing hormone (LH) and granulosa cell LH receptor (LH-R) in poor responder patients who underwent controlled ovarian stimulation. Expression levels of LH-R mRNA in granulosa cells was investigated and compared with oocyte morphology, oocyte maturity and fertilization rate. Methods: Granulosa cells were obtained from 30 patients who underwent in vitro fertilization (IVF) at Dr. Cipto Mangunkusumo Hospital, Jakarta. The patients were divided into two groups: group I (n=10) poor responders; and group II (n=20) non-poor responders. After the extraction of total RNA from granulosa cells, semi-quantitative RT-PCR was performed and the amount of LH-R mRNA was quantified. The relative values were calculated as the ratio of LH-R mRNA and actin beta mRNA. Statistical analysis was performed using Mann-Whitney test and Spearman correlation. Results: The relative value of LH-R mRNA was higher in group I compared with group II (27.37[0.00-28939.37] vs 0.00[0.00-7196.12]). Oocyte maturity (r=0.267) and morphology (r=0.267) in group I consistently showed a positive correlation with LH-R mRNA; in group II a negative correlation with LH-R mRNA was shown for oocyte maturity (r= -0.552) and morphology (r= -0.164). Group I had a positive correlation between LH-R expression with fertilization rate (r=0.430), and group II showed a negative correlation (r=-0.340). Conclusions: The expression of LH-R mRNA has a positive correlation with oocyte quality in poor responder patients and a negative correlation in non-poor responders. Our study suggests an optimal expression of LH- R mRNA in granulosa cells during controlled ovarian stimulation to obtain good quality oocytes.
Highlights
In 2012, the World Health Organization reported that 80 million reproductive-aged couples, which constitutes 10% of the total number of couples globally, have issues related to infertility[1]
Our study suggests an optimal expression of luteinizing hormone (LH)- R mRNA in granulosa cells during controlled ovarian stimulation to obtain good quality oocytes
We found that granulosa LH receptor (LH-R) expression is higher in the poor responders (27.37 (0.00-28939.37) arbitrary unit) than in non-poor responders (0.00 (0.00-7196.12)), but this was not statistically significant between the groups (p=0.169)
Summary
In 2012, the World Health Organization reported that 80 million reproductive-aged couples, which constitutes 10% of the total number of couples globally, have issues related to infertility[1]. The In Vitro Fertilization World Report 2000 showed that the average number of pregnancy and births post-IVF is 26.7% and 18.6%, respectively[4]. As reported by the Society of Assisted Reproductive Technology, the success rate of IVF in women under 35 years of age is 41–43%6. This success rate declines as a woman’s age increases, especially for women who are older than 35 years old and those who are not adequately affected by gonadotropin treatment ( known as a poor responders)[7]. Expression levels of LH-R mRNA in granulosa cells was investigated and compared with oocyte morphology, oocyte maturity and fertilization rate. Methods: Granulosa cells were obtained from 30 patients who underwent in vitro fertilization (IVF) at Dr Cipto Mangunkusumo Hospital, Jakarta. Oocyte maturity (r=0.267) and morphology (r=0.267) in group I consistently showed a positive correlation with LH-R mRNA; in group II a negative correlation with LH-R mRNA was shown for oocyte maturity
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