SERUM LEVELS OF FREE ANDROSTENEDIONE, TESTOSTERONE AND ESTRADIOL ARE LOWER IN THE FOLLICULAR PHASE OF CONCEPTIONAL THAN OF NONCONCEPTIONAL CYCLES AFTER OVARIAN STIMULATION WITH A GONADOTROPIN-RELEASING-HORMONE AGONIST PROTOCOL

被引:14
作者
ANDERSEN, CY
ZIEBE, S
机构
[1] Laboratory of Reproductive Biology, Department of Obstetrics and Gynaecology Y, Section 5821, Rigshospitalet, DK-2100 Copenhagen ø
关键词
ANDROGENS; FREE STEROIDS; IVF; STEROID-BINDING PROTEINS;
D O I
10.1093/oxfordjournals.humrep.a137575
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Serum concentrations of total and free androstenedione, testosterone and oestradiol were followed during the follicular phase in women undergoing ovarian stimulation for treatment by in-vitro fertilization and embryo transfer (IVF-ET) and compared to those in natural unstimulated cycles. In addition, 10 conceptional and 18 non-conceptional cycles were compared in an attempt to understand the background for successful IVF cycles. The ultra-short gonadotrophin-releasing hormone agonist protocol was used for ovarian stimulation. Throughout the follicular phase, levels of total and free androstenedione and oestradiol were significantly lower in conceptional than in non-conceptional IVF cycles. In addition, levels of free testosterone during the follicular phase were significantly lower in women who conceived compared to non-conceptional IVF cycles, whereas levels of total testosterone were similar. Levels of both free and total androstenedione increased significantly from the second day of the menstrual cycle until oocyte retrieval in non-conceptional IVF cycles, whereas levels in conceptional IVF cycles and unstimulated cycles showed no increase. On the day of oocyte retrieval levels of free and total androstenedione were significantly higher in non-conceptional IVF cycles than in conceptional IVF cycles and unstimulated cycles, which were similar. This study suggests that appropriate levels of free biologically active androgens and oestradiol are important parameters for successful conception. Supra-optimal levels of these steroids might affect follicles, pre-embryos and/or endometrium negatively. The high levels of steroids may be caused by an increased responsiveness of the ovarian cells to either luteinizing hormone or follicle stimulating hormone or both, rather than by the actual circulating levels of gonadotrophins during the follicular phase.
引用
收藏
页码:1365 / 1370
页数:6
相关论文
共 26 条
[1]  
Chappel S.C., Howies C., Reevaluation of the roles of luteinizing hormone and follicle-stimulating hormone in the ovulatory process, Hum. Reprod, 6, pp. 1206-1212, (1991)
[2]  
Dunn J.F., Nisula B.C., Rodbard D., Transport of steroid hormones: Binding of 21 endogenous steroids to both testosteronebinding globulin and corticosteroid-binding globulin in human plasma, J. Clin. Endocrinol. Metab, 53, (1981)
[3]  
Elans R., Measurement of free hormones in blood, Endocr. Rev, 11, pp. 5-46, (1990)
[4]  
Erickson G.F., Magoffin D.A., Garzo V.G., Cheung A.P., Chang R.F., Granulosa cells of polycystic ovaries: Are they normal or abnormal?, Hum. Reprod, 7, pp. 293-299, (1992)
[5]  
Gustafson O., Lunell N.O., Nylund L., Pousette A., Akerlof E., Carlstrom K., Sex hormone-binding globulin, oestradiol-17/3, progesterone and testosterone at stimulation and after embryo transfer during in-vitro fertilization, Hum. Reprod, 6, pp. 1039-1042, (1991)
[6]  
Harlow C.R., Shaw H.J., Hillier S.G., Hodges J.K., Factors influencing follicle-stimulating hormone-responsive steroidogenesis in marmoset granulosa cells: Effects of androgens and the stage of follicular maturity, Endocrinology, 12, pp. 2780-2787, (1988)
[7]  
Hillier S.G., Yong E.L., Illingworth P.J., Baird D.T., Schwall R.H., Mason A.J., Effect of recombinant inhibin on androgen synthesis in cultured human thecal cells, Mol. Cell. Endocrinol, 75, (1991)
[8]  
Howies C.M., Macnamee M.C., Edwards R.G., Goswamy R., Steptoe P.C., Effect of high tonic levels of luteinizing hormone on outcome of in vitro fertilisation, Lancet, 2, pp. 521-522, (1986)
[9]  
Howies C.M., Macnamee M.C., Edwards R.G., Follicular development and early luteal function of conception and nonconception cycles after human in-vitro fertilization: Endocrine correlates, Hum. Reprod, 2, pp. 17-22, (1987)
[10]  
Kobayashi T., Oda T., Yoshimura Y., Takehara Y., Natori M., Nozawa S., Androstenedione and progesterone concentrations in preovulatory follicular fluid correlate with successful fertilization and cleavage of human oocytes in vitro, Fertil. Steril, 56, pp. 301-305, (1991)