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Fertil Steril. 2014 Jan;101(1):138-146.e3. doi: 10.1016/j.fertnstert.2013.09.033. Epub 2013 Oct 29.

Impact of final oocyte maturation using gonadotropin-releasing hormone agonist triggering and different luteal support protocols on endometrial gene expression.

Author information

1
IVI Madrid, Madrid, Spain.
2
IVIOMICS SL, Paterna, Spain.
3
Fundación IVI, Valencia University INCLIVA, Valencia, Spain.
4
IVI Valencia, Valencia University, Valencia, Spain.
5
IVI Madrid, Madrid, Spain; Rey Juan Carlos University, Madrid, Spain. Electronic address: juan.garcia.velasco@ivi.es.

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.

DESIGN:

Prospective, randomized, controlled trial.

SETTING:

University-affiliated private assisted-reproduction center.

PATIENT(S):

25 healthy oocyte donors undergoing controlled ovarian stimulation.

INTERVENTION(S):

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.

MAIN OUTCOME MEASURE(S):

Gene expression using the Endometrial Receptivity Array (ERA) and pathway and network analysis of study groups 1-4 compared with controls (group 5).

RESULT(S):

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.

CONCLUSION(S):

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.

CLINICAL TRIAL REGISTRATION NUMBER:

EudraCT 2011-003250-34.

KEYWORDS:

Endometrial receptivity; GnRH agonist; gene expression; ovarian stimulation

[Indexed for MEDLINE]

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