The Relationship Of Follicle-stimulating Hormone Receptors Expression On Granulosa Cells With Ovarian Response And Pregnancy Parameters In IVF-ET Cycles

Objective: To investigate the relationship between FSHR expression on GCs and the ovarian response to gonadotropin stimulation in IVF cycles; To investigatehe relationship between FSHR expression and the IVF outcome.Methods: Sixty ovulatory women with infertility caused by unknown origin or tubal factor were included in this study from 2006.7 to 2008.1. The gonadorelin antagonist protocol was operated in IVF cycles. Granulosa cells were obtained from follicular aspirates during oocyte retrieval, and blood samples were collected at the day of oocyte retrieval. According to the number of oocyte retrieval, the patients were divided into three groups: high responders (oocytes≥14, n=24), normal responders (oocytes 4-13, n=20) and poor responders (oocytes≤3, n=16). There is no age diference in three groups. The expression levels of FSHR on granulosa cells were measured by semiquantitative western-blot(WB). Serum E2 levels were measured by radioimmunoassay. The doses of gonadotropin used, the number of follicles and eggs, the ET duration, the fertilization rate and cleavage rate were recorded, and the pregnancy rate was followed up. Statistical analysis was done by SPSS 13.0 for windows.Results: 1. The FSHR was expressed exclusively on the granulosa cells of diferent ovarian responses (high responders, normal responders and poor responders). The FSHR level in poor responders was much lower than those in normal responders and high responders (P<0.05,P<0.005, respectively). The expression of FSHR level in high responders was higher than this in normal responders (P< 0.05).2. Poor responders needed more ampoules of FSH for stimulation than normal responders and high responders (P< 0.05).3. The number of follicles, oocytes retrieved and frozen embryos in poor responders were significantly fewer than those in normal responders and high responders (P<0.05).The fertilization rate in poor responders was much lower than those in normal responders and high responders (P<0.05).But the cleavage, implantation and pregnancy rate in poor responders were similar to those in normal responders and high responders (P>0.05).4. The FSHR level was positively correlated with the number of antral follicle,cycle day 7 antral follicle count,count follicles, eggs,the number of mature eggs,the serum E2 levels,fertilization rate and high-quailty embryo rate(r=0.59,0.72,0.76, 0.83, 0.73,0.59, 0.24,0.34 P<0.05). However, the FSHR level was correlated with the pregnancy rate (P> 0.05)5. No diference of FSHR level was found between the women who succeeded in becoming pregnant and those who failed (P> 0.05).Conclusion: 1. The ovarian response is associated with the expression of the FSHR on granulose cells. In high responders the FSHR level is relative higher, whereas in poor responders the FSHR is insufficient.2. Poor responders need more ampoules of FSH for stimulation than normal responders and high responders, but increasing FSH dosage can not improve their ovarian responses.3. The FSHR level has a significantly positive correlation with the follicles number,eggs number and serum E2 levels, indicating FSHR expression may directly afect the follicle development.4. There is no correlation between the FSHR expression and the rate of fertilization,cleavage, implantation and pregnancy.5. The comparison between diferent ovarian responses shows similarity in the rate,but the cumulative pregnancy rate in three groups may be various due to the diferent number of oocytes and embryos.