RESUMO
Granulosa cells control oocyte maturation through paracrine signalling and changes to the microenvironment around the oocyte. Apoptosis occurs as a physiological mechanism of granulosa cell renewal, but how it relates with the ovarian response to induced ovulation is still unclear. Therefore, this study evaluated apoptosis-related gene expression levels in granulosa cells of patients undergoing controlled ovarian stimulation. We enrolled prospectively 59 consecutive IVF patients referred to a tertiary academic hospital for couple infertility treatment. Luteinized granulosa cells were isolated from follicular fluid and the RNA was extracted, reverse-transcribed and the gene expression of apoptosis inducers (caspase-3, caspase-8 and bax) and inhibitor (Bcl-2) was quantified by real-time polymerase chain reaction. Caspase-3 gene expression correlated negatively with the number of pre-ovulatory follicles (Spearman's r = -0.308), the number of collected oocytes (r = -0.451), the number of mature oocytes (r = -0.526), the number of fertilized oocytes (r = -0.439) and the number of viable embryos (r = -0.443, all statistically significant at p < 0.02 level). No such associations were found with caspase-8, bax or bcl-2. These preliminary findings suggest that increased caspase-3 gene expression in granulosa cells is associated with a worse ovulatory response in humans.
Assuntos
Caspase 3/metabolismo , Hormônio Liberador de Gonadotropina/análogos & derivados , Células da Granulosa/enzimologia , Nafarelina/farmacologia , Oócitos/fisiologia , Indução da Ovulação/métodos , Caspase 3/genética , Gonadotropina Coriônica/farmacologia , Estudos de Coortes , Feminino , Fármacos para a Fertilidade Feminina/farmacologia , Hormônio Foliculoestimulante/farmacologia , Regulação Enzimológica da Expressão Gênica/efeitos dos fármacos , Hormônio Liberador de Gonadotropina/farmacologia , Humanos , Oócitos/metabolismoRESUMO
PURPOSE: A prospective study was conducted to compare the efficiency of ovarian blockade with nafarelin versus leuprolide in a population whose indication for assisted reproduction was the male factor METHODS: A total of 238 patients were assigned at random to two types of treatment: Group I (119 aspirations), nafarelin (Synarel, Searle), 200 microg by the nasal route twice a day, and Group II (119 aspirations), leuprolide acetate (Lupron, Abbott), 0.5 mg by the subcutaneous route once a day. Both types of blockade were started during the 2nd phase (21st day of the menstrual cycle) and were continued until the day of HCG (5,000-10,000 IU). All patients received a fixed dose of recombinant FSH for 7 days and on the 8th day of stimulation the doses started to be adapted according to ovarian response. RESULTS: Patients' age did not differ (p = 0.93) between Group 1 (34.1 +/- 3.79) and Group II (34 +/- 4.64). The number of oocytes retrieved from Group I (10.5 +/- 5.93) was also similar (p = 0.57) to that retrieved from Group II (10.2 +/- 6.36). In addition, there was no difference (p = 0.58) in the number of oocytes retrieved at Metaphase II between Group I (8.2 +/- 4.61) and Group II (7.9 +/- 5.2). Fertilization rates and embryo scores were similar (p = 0.81 and p = 0.25, respectively) for Group I (67.5% +/- 21.3 and 34.4% +/- 14.4) and Group II (68.1% +/- 23and32.2% +/- 14.7, respectively). Inaddition, pregnancy rates per puncture and per embryo transfer and implantation rates were similar for Group I (30.2, 31.3, and 16.2%, respectively) then compared with Group 11(24.4, 25.2, and 12.6%, respectively) (p = 0.38, p = 0.37, and p = 0.22, respectively). CONCLUSIONS: Implantation and pregnancy rates per puncture and per embryo transfer are not statistically significant in the nafarelin group when compared with leuprolide group.