The role of the follicle stimulating hormone receptors genotype in the response to FSH in women undergoing controlled ovarian stimulation

Abstract

OBJECTIVE: To investigate the role of follicle stimulating hormone receptor (FSHR) genotype, in response to FSH in women undergoing controlled ovarian stimulation and to examine the association of ovarian response variables with the total HMG dose in different allelic variant genotypes.DESIGN: Prospective clinical trial.MATERIALS AND METHODS: Women undergoing controlled ovarian hyperstimulation were subjected molecular studies DNA isolation, DNA amplification and RFLP analysis. Through this molecular study, the studied women are classified into three groups: Asn680Ser variant, namely, aa (680Asn/Asn), as (680Asn/Ser) and ss (680Ser/Ser), of the FSHR gene. follicular development was monitored by transvaginal ultrasonography after 6 days of stimulation and then every other day. Sonography was performed daily when the leading follicle exceeded 14 mm in diameter. Ovulation was induced by 10,000 IU human CG (hCG), IM, when at least two follicle was 20 mm in diameter. Oocytes were collected by transvaginal Ultrasound-guided aspiration under general anesthesia was generally performed approximately 36 hours after hCG administration. Intracytoplasmic sperm injection was performed in all patients.RESULTS: The frequency distributions of FSHR allelic variants were 20 patients (37%) for the allelic variant (aa), 20 patients (37%) for allelic variant (ss) and 14 patients (26%) for the allelic variant (as) patients. The mean number of HMG ampoules given to the studied patients was 24.6 ± 5.1 in allelic (aa) patients, 41.3 ± 4.8 in allelic (ss) patients, and 37.5 ± 6.3 in allelic (as) patients and showed statistically significant difference (p <.0001). In patients belonging to allelic variant (aa), the larger the HMG dose, the less the oocytes number will the patient develop, the more the E2HCG will the patient produce and the more the MII oocytes that will develop. In patients belonging to allelic variant (ss), the larger the dose of HMG, the more the oocytes number will the patient develop, the more the E2HCG will the patient produce and the more the MII oocytes that will develop. In patients belonging to allelic variant (as), the results are roughly similar to that observed in allelic (aa) group.CONCLUSIONS: We can conclude that a different ovarian response to FSH stimulation do occur, depending on the FSHR genotype and indicates that subtle genetic changes might fine-tune the hormonal regulation of reproduction. knowing the different sensitivity to FSH, depending on the FSHR genotype, could be important to prevent OHSS. OBJECTIVE: To investigate the role of follicle stimulating hormone receptor (FSHR) genotype, in response to FSH in women undergoing controlled ovarian stimulation and to examine the association of ovarian response variables with the total HMG dose in different allelic variant genotypes. DESIGN: Prospective clinical trial. MATERIALS AND METHODS: Women undergoing controlled ovarian hyperstimulation were subjected molecular studies DNA isolation, DNA amplification and RFLP analysis. Through this molecular study, the studied women are classified into three groups: Asn680Ser variant, namely, aa (680Asn/Asn), as (680Asn/Ser) and ss (680Ser/Ser), of the FSHR gene. follicular development was monitored by transvaginal ultrasonography after 6 days of stimulation and then every other day. Sonography was performed daily when the leading follicle exceeded 14 mm in diameter. Ovulation was induced by 10,000 IU human CG (hCG), IM, when at least two follicle was 20 mm in diameter. Oocytes were collected by transvaginal Ultrasound-guided aspiration under general anesthesia was generally performed approximately 36 hours after hCG administration. Intracytoplasmic sperm injection was performed in all patients. RESULTS: The frequency distributions of FSHR allelic variants were 20 patients (37%) for the allelic variant (aa), 20 patients (37%) for allelic variant (ss) and 14 patients (26%) for the allelic variant (as) patients. The mean number of HMG ampoules given to the studied patients was 24.6 ± 5.1 in allelic (aa) patients, 41.3 ± 4.8 in allelic (ss) patients, and 37.5 ± 6.3 in allelic (as) patients and showed statistically significant difference (p <.0001). In patients belonging to allelic variant (aa), the larger the HMG dose, the less the oocytes number will the patient develop, the more the E2HCG will the patient produce and the more the MII oocytes that will develop. In patients belonging to allelic variant (ss), the larger the dose of HMG, the more the oocytes number will the patient develop, the more the E2HCG will the patient produce and the more the MII oocytes that will develop. In patients belonging to allelic variant (as), the results are roughly similar to that observed in allelic (aa) group. CONCLUSIONS: We can conclude that a different ovarian response to FSH stimulation do occur, depending on the FSHR genotype and indicates that subtle genetic changes might fine-tune the hormonal regulation of reproduction. knowing the different sensitivity to FSH, depending on the FSHR genotype, could be important to prevent OHSS.