Authors: Timur Gurgan Debbie Montjean Aygul Demirol Yves J R Menezo
Publish Date: 2014/03/18
Volume: 31, Issue: 6, Pages: 657-665
Abstract
FSH is a key hormone in the regulation of follicular development Together with the EGF network these molecules mediate oocyte maturation and competence in preparation for the action of LH FSH isoforms regulate distinct biological pathways and have specific effects on granulosa cell function and maturation of the ovarian follicle Their dynamic interactions occur during the follicular cycle shortliving forms are predominant in the preovulatory phase whereas longacting molecules characterize the lutealfollicular transition Recombinant FSH rFSH molecules have a reduced number of isoforms and are less acidic with a shorter halflife We have investigated sequential stimulation comparing hFSH + rFSH vs rFSH alone and hFSH alone for the entire stimulation phase Sequential stimulation leads to an E2 per MII oocyte ratio that is much lower than is seen during treatment with the two drugs individually Although there is a positive tendency in favor of the sequential treatment there was no significant difference in pregnancy rates even taking frozen embryos into consideration The cumulus cell transcriptome varies considerably between the treatments although with no clear significance When comparing pregnant vs nonpregnant patients in general a decrease in mRNA expression can be observed in the pregnant patients especially in expression of folic acid receptor 1 and ovostatin 2 This indicates that material has been transferred from CC to the oocyte However a common observation in the literature is that variations in the transcriptome of the cumulus cells are highly dependent upon the patient genotype the potential for applying this strategy as a basis for selecting embryos is at the very least questionableCapsule A sequential stimulation protocol hFSH + recFSH has been compared to homogenous h FSH and rFSH protocol in three group of 30 patients Clinical results and Cumulus cells CC cellsgene expression has been analyzed The sequential treatment leads to a E2 per MII oocyte ratio more physiological and much lower than the other treatment It leads to better but not significant pregnancy rates even taking frozen embryos into consideration hFSH treatments appears to be rather associated with depletion rather than overexpression of PolyA mRNAs this means that the trophic transfer towards the oocyte has been completed The CC cells mRNA content in the pregnant patients is depleted when compared to the non pregnant group The usefulness of CC transcriptome analysis for selecting the best embryos is at the very least questionable as some published statements are rather misleading
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