Role of Lh polymorphisms and r-hLh supplementation in GnRh agonist treated ART cycles: A cross sectional study.
Eur J Obstet Gynecol Reprod Biol
; 222: 119-125, 2018 Mar.
Article
em En
| MEDLINE
| ID: mdl-29408742
ABSTRACT
STUDY OBJECTIVES:
To investigate the effect of N312S polymorphism in the LHCGR gene as a predictive pharmacogenetic marker on clinical and embryological parameters and determining the need of r-hLH supplementation combine with r-hFSH in patients undergoing ART treatment. STUDYDESIGN:
In a cross-sectional study, a retrospective analysis of women (nâ¯=â¯553), who underwent controlled ovarian stimulation treatment protocol was conducted during the years 2012-2014. R-hFSH (Gonal-F, Merck Serono) was administered to all patients undergoing ART cycle after initiating long luteal gonadotrophin-releasing hormone (GnRH) agonist down-regulation. R-hLH was supplemented based on P.C. Wong criteria. N312S genotype was determined using sequencing methodology. The mean r-hFSH, r-hLH doses, total number of oocytes, cleavage rates of embryos and clinical pregnancy were recorded. The association between the r-hLH supplementation and LHCGR N312S polymorphism and clinical pregnancy rates was determined using regression analysis by SPSS.RESULTS:
19.7% of women were homozygous for A allele encoding asparagine (N/N), 45.7% were heterozygous (N/S) and 34.6% were homozygous (S/S) for G allele encoding serine. Women heterozygous (N/S) or homozygous (S/S) for serine showed a higher requirement for r-hLH (OR, 95% p-trendâ¯=â¯<0.0001) compared to those homozygous for asparagine (N/N). Homozygous G allele was also associated with higher daily and total r-hLH dose per treatment cycle p-trendâ¯=â¯<0.0001. Though, the total no of oocytes (14.87⯱â¯4.95 vs 12.98⯱â¯5.39 and 13.58⯱â¯5.45), Gr-I quality embryos (2.61⯱â¯1.81 vs 2.18⯱â¯1.96 and 1.98⯱â¯2.05) were significantly higher in women homozygous for A allele compared to women with heterozygous and homozygous for G allele, clinical pregnancy rates were significantly more in women with for G allele after excluding patients with PCOS and endometriosis conditions (Pâ¯<â¯0.04).CONCLUSION:
The present findings reveal that women heterozygous and homozygous for G allele required higher doses of r-hLH supplementation and these women were shown to have higher clinical pregnancy rates.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Indução da Ovulação
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Resistência a Medicamentos
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Hormônio Luteinizante
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Hormônio Liberador de Hormônio do Crescimento
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Receptores LHRH
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Polimorfismo de Nucleotídeo Único
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Infertilidade Feminina
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article