Does gonadotropin-releasing hormone agonist cause luteolysis by inducing apoptosis of the human granulosa-luteal cells?

J Assist Reprod Genet. 2021 Sep;38(9):2301-2305. doi: 10.1007/s10815-021-02226-w. Epub 2021 May 24.

Abstract

Objectives: To evaluates the effect of different modes of final follicular maturation triggering on the degree of apoptosis of granulosa cells (GCs) and the potential effect on progesterone secretion.

Methods: Thirty patients undergoing controlled ovarian hyperstimulation for IVF who received hCG, GnRH agonist, or dual trigger for final follicular maturation were included in the study. Granulosa cells were obtained at the time of oocyte retrieval. The proportion of apoptotic cells was evaluated via TUNEL and immunohistochemistry.

Results: The proportion of apoptotic cells was significantly higher in the GnRH agonist-alone group compared to hCG-alone and the dual trigger groups (13.5 ± 1.5% vs. 7.8% ± 1.8 vs. 10.1% ± 2, respectively, P < 0.01). Moreover, the expression of active-caspase-3 was also significantly increased in the GnRH agonist-alone group compared with the hCG-alone and the dual trigger groups (15.5% ± 2.9 vs. 8.4% ± 1.6 vs. 12.7% ± 2.6, respectively, P < 0.01). The progesterone levels measured in the granulosa-luteal cell culture medium after 24 h of incubation were similar between the three groups.

Conclusions: The levels of apoptosis are increased after GnRH agonist/dual trigger. The increased apoptosis might be one of the culprit of the subsequent premature demise of the corpus luteum post GnRH agonist trigger.

Keywords: Apoptosis; Dual trigger; GnRH agonist trigger.

MeSH terms

  • Adult
  • Apoptosis*
  • Chorionic Gonadotropin / pharmacology*
  • Female
  • Fertilization in Vitro / methods
  • Gonadotropin-Releasing Hormone / agonists*
  • Humans
  • Infertility, Male / physiopathology*
  • Luteal Cells / drug effects
  • Luteal Cells / pathology*
  • Luteolysis*
  • Male
  • Oocyte Retrieval
  • Ovulation Induction / methods*
  • Pregnancy
  • Reproductive Control Agents / pharmacology

Substances

  • Chorionic Gonadotropin
  • Reproductive Control Agents
  • Gonadotropin-Releasing Hormone