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A pilot study to search possible mechanisms of ultralong gonadotropin-releasing hormone agonist therapy in IVF-ET patients with endometriosis.

Abstract

BACKGROUND

Additional treatment with a gonadotropin-releasing hormone (GnRH) agonist (GnRHa) before IVF-ET (ultralong GnRHa therapy) has been reported to improve the outcome of IVF-ET in endometriosis patients. However, the mechanism of ultralong GnRHa therapy is unclear. It is suggested that inflammatory cytokines and oxidative stress contribute to infertility in endometriosis patients. Therefore, in order to search a possible mechanism of ultralong GnRHa therapy, we investigated the effect of ultralong GnRHa therapy on intrafollicular concentrations of tumor necrosis factor alpha (TNFα), oxidative stress markers, and antioxidants in patients with endometriosis.

METHODS

Twenty-three infertile women with Stage III or IV endometriosis were recruited for this study. Eleven patients received three courses of GnRHa (1.8 mg s.c. every 28 days), followed by a standard controlled ovarian hyperstimulation (COH) for IVF-ET (ultralong group). The other 12 patients received a standard COH with mid-luteal phase GnRHa down-regulation (control group). The numbers of matured follicles and retrieved oocytes, fertilization rates, implantation rates, clinical pregnancy rate, and intrafollicular concentrations of TNFα, 8-hydroxy-2'-deoxyguanosine (8-OHdG) and hexanoyl-lysine adduct (HEL) as oxidative stress markers, and melatonin and Cu,Zu-superoxide dismutase (Cu,Zn-SOD) as antioxidants were compared between the two groups.

RESULTS

The numbers of mature follicles and retrieved oocytes, and fertilization rates did not differ between the two groups. Implantation rates and pregnancy rates tended to be higher in the ultralong group (21.4% and 27.3%, respectively) compared with the control group (8.3% and 8.3%, respectively). TNFα concentrations in the follicular fluid were significantly lower in the ultralong group (5.8 ± 3.2 pg/ml) than those in the control group (10.6 ± 3.2 pg/ml). Follicular concentrations of 8-OHdG concentrations were significantly lower in the ultralong group (5.7 ± 1.6 ng/ml) than those in the control group (6.6 ± 1.5 ng/ml), while melatonin concentrations were significantly higher in the ultralong group (139 ± 46 pg/ml) compared with the control group (86 ± 27 pg/ml).

CONCLUSIONS

Ultralong GnRHa therapy reduces the detrimental effects of cytotoxic cytokines and oxidative stress in the ovary in patients with endometriosis.

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    Source

    Journal of ovarian research 7: 2014 Oct 21 pg 100

    MeSH

    Adult
    Biomarkers
    Deoxyguanosine
    Endometriosis
    Female
    Fertilization in Vitro
    Gonadotropin-Releasing Hormone
    Humans
    Infertility, Female
    Melatonin
    Ovulation Induction
    Oxidative Stress
    Pilot Projects
    Pregnancy
    Pregnancy Rate
    Superoxide Dismutase
    Treatment Outcome
    Tumor Necrosis Factor-alpha

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    25331066

    Citation

    Tamura, Hiroshi, et al. "A Pilot Study to Search Possible Mechanisms of Ultralong Gonadotropin-releasing Hormone Agonist Therapy in IVF-ET Patients With Endometriosis." Journal of Ovarian Research, vol. 7, 2014, p. 100.
    Tamura H, Takasaki A, Nakamura Y, et al. A pilot study to search possible mechanisms of ultralong gonadotropin-releasing hormone agonist therapy in IVF-ET patients with endometriosis. J Ovarian Res. 2014;7:100.
    Tamura, H., Takasaki, A., Nakamura, Y., Numa, F., & Sugino, N. (2014). A pilot study to search possible mechanisms of ultralong gonadotropin-releasing hormone agonist therapy in IVF-ET patients with endometriosis. Journal of Ovarian Research, 7, p. 100. doi:10.1186/s13048-014-0100-8.
    Tamura H, et al. A Pilot Study to Search Possible Mechanisms of Ultralong Gonadotropin-releasing Hormone Agonist Therapy in IVF-ET Patients With Endometriosis. J Ovarian Res. 2014 Oct 21;7:100. PubMed PMID: 25331066.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A pilot study to search possible mechanisms of ultralong gonadotropin-releasing hormone agonist therapy in IVF-ET patients with endometriosis. AU - Tamura,Hiroshi, AU - Takasaki,Akihisa, AU - Nakamura,Yasuhiko, AU - Numa,Fumitaka, AU - Sugino,Norihiro, Y1 - 2014/10/21/ PY - 2014/08/26/received PY - 2014/10/11/accepted PY - 2014/10/22/entrez PY - 2014/10/22/pubmed PY - 2015/8/15/medline SP - 100 EP - 100 JF - Journal of ovarian research JO - J Ovarian Res VL - 7 N2 - BACKGROUND: Additional treatment with a gonadotropin-releasing hormone (GnRH) agonist (GnRHa) before IVF-ET (ultralong GnRHa therapy) has been reported to improve the outcome of IVF-ET in endometriosis patients. However, the mechanism of ultralong GnRHa therapy is unclear. It is suggested that inflammatory cytokines and oxidative stress contribute to infertility in endometriosis patients. Therefore, in order to search a possible mechanism of ultralong GnRHa therapy, we investigated the effect of ultralong GnRHa therapy on intrafollicular concentrations of tumor necrosis factor alpha (TNFα), oxidative stress markers, and antioxidants in patients with endometriosis. METHODS: Twenty-three infertile women with Stage III or IV endometriosis were recruited for this study. Eleven patients received three courses of GnRHa (1.8 mg s.c. every 28 days), followed by a standard controlled ovarian hyperstimulation (COH) for IVF-ET (ultralong group). The other 12 patients received a standard COH with mid-luteal phase GnRHa down-regulation (control group). The numbers of matured follicles and retrieved oocytes, fertilization rates, implantation rates, clinical pregnancy rate, and intrafollicular concentrations of TNFα, 8-hydroxy-2'-deoxyguanosine (8-OHdG) and hexanoyl-lysine adduct (HEL) as oxidative stress markers, and melatonin and Cu,Zu-superoxide dismutase (Cu,Zn-SOD) as antioxidants were compared between the two groups. RESULTS: The numbers of mature follicles and retrieved oocytes, and fertilization rates did not differ between the two groups. Implantation rates and pregnancy rates tended to be higher in the ultralong group (21.4% and 27.3%, respectively) compared with the control group (8.3% and 8.3%, respectively). TNFα concentrations in the follicular fluid were significantly lower in the ultralong group (5.8 ± 3.2 pg/ml) than those in the control group (10.6 ± 3.2 pg/ml). Follicular concentrations of 8-OHdG concentrations were significantly lower in the ultralong group (5.7 ± 1.6 ng/ml) than those in the control group (6.6 ± 1.5 ng/ml), while melatonin concentrations were significantly higher in the ultralong group (139 ± 46 pg/ml) compared with the control group (86 ± 27 pg/ml). CONCLUSIONS: Ultralong GnRHa therapy reduces the detrimental effects of cytotoxic cytokines and oxidative stress in the ovary in patients with endometriosis. SN - 1757-2215 UR - https://www.unboundmedicine.com/medline/citation/25331066/A_pilot_study_to_search_possible_mechanisms_of_ultralong_gonadotropin_releasing_hormone_agonist_therapy_in_IVF_ET_patients_with_endometriosis_ L2 - https://ovarianresearch.biomedcentral.com/articles/10.1186/s13048-014-0100-8 DB - PRIME DP - Unbound Medicine ER -