[Effects of oral contraceptive pretreatment on controlled ovarian hyperstimulation and outcomes of IVF-ET].

OBJECTIVE: To investigate the effects of oral contraceptive pretreatment (OCP) in patients with polycystic ovarian syndrome (PCOS) undergoing controlled ovarian hyperstimulation for IVF-ET. METHODS: We randomly divided 85 patients with P-COS undergoing IVF-ET into an OCP (n = 53) and a control group (n = 32), the former received OCP, while the latter did not before the cycle. We retrospectively analyzed the data of the patients for the ovulation promoting effect of OCP and its influence on the incidence of ovarian hyperstimulation syndrome (OHSS) and outcomes of IVF-ET. RESULTS: Compared with the control group, OCP significantly reduced the formation of ovarian cyst (P < 0.05), remarkably increased the duration of gonadotropin stimulation and consumption (P < 0.01) , and markedly raised the percentage of mature ova (87.92% vs 92.85%, P < 0.05). But no significant differences were observed between the two groups in the incidences of moderate and severe OHSS, number of retrieved oocytes, and rates of fertilization, miscarriage and clinical pregnancy. CONCLUSION: OCP for patients with PCOS can help to control the time of ovarian stimulation, improve the synchronism of follicular development, and increase the duration of gonadotropin stimulation and consumption, but cannot change the incidences of moderate and severe OHSS.

Low-grade chronic inflammation in the peripheral blood and ovaries of women with polycystic ovarian syndrome.

The purpose of this study was to investigate chronic inflammation in the peripheral blood and ovaries of patients with polycystic ovary syndrome (PCOS). 86 PCOS patients and 50 controls were randomly enrolled in the study. Serum follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), blood routine test, lipid metabolism index, inflammation cytokines were detected. Ovary samples from PCOS group and control group were collected for macrophage and lymphocyte immunohistochemistry staining. Patients with PCOS showed significantly higher serum CRP, lymphocytes, monocytes, eosinophilic granulocytes, as well as higher triglycerides (TG), TNF-α and IL-6. PCOS ovary had greater number of macrophages and lymphocytes immersed throughout. In conclusion, PCOS patients exhibited hypertriglyceridemia and chronic inflammation, with elevated peripheral lymphocytes, monocytes, and eosinophilic granulocytes. In addition, their ovaries showed persistent chronic inflammation with a larger number of inflammatory cells immersed.

[Effect of luteinizing hormone vs follicular stimulating hormone ratio on anti-Müllerian hormone secretion and folliculogenesis in patients with polycystic ovarian syndrome].

OBJECTIVE: To investigate characteristics of anti-Müllerian hormone (AMH) secretion and mechanism of aberrant folliculogenesis by the ratio of luteinizing hormone (LH)/follicle-stimulating hormone (FSH) in polycystic ovarian syndrome (PCOS) patients. METHODS: Base on the ratio of LH/FSH, total 95 patients with PCOS were divided into two groups, including 49 cases in higher ratio group (LH/FSH ≥ 2) and 46 cases in normal ratio group (LH/FSH < 2) matched with 62 infertile cases with tubal factor and regular menstruation as control group. Body mass index (BMI) were calculated in all objectives. The serum AMH were detected by enzyme linked immunosorbent assay (ELISA). Ovarian sexual hormones, fasting blood glucose, insulin and lipid were measured by chemiluminescence method. The correlation between AMH and metabolic index was analyzed by multilinear regression. RESULTS: (1) AMH: the serum level of AMH were (7.2 ± 4.3) µg/L in higher LH/FSH group, (5.2 ± 3.8) µg/L in normal LH/FSH group and (3.7 ± 2.2) µg/L in control group, which all reached significant difference among those 3 groups (P < 0.01). (2) The correlation between AMH and biological metabolic index: estradiol (E(2)) was negatively correlated with serum level of AMH in higher LH/FSH ratio group (r = -0.318). The serum level of AMH were positively correlated with BMI, fasting glucose, homeostasis model assessment insulin resistance index (HOMA-IR) in normal LH/FSH ratio group (r = 0.493, 0.362, 0.303). After controlling affect factors, serum levels of AMH were positively correlated with LH/FSH in higher LH/FSH ratio group (r = 0.301), but negatively correlated with E2 (r = -0.429). However, in normal LH/FSH group, serum level of AMH was only positively correlated with BMI (r = 0.428). CONCLUSION: The PCOS patients with higher LH/FSH ratio are primarily caused by hypothalamic-pituitary dysfunction, while the PCOS patients with normal LH/FSH ratio are mainly caused by metabolic disorders.

Study of RNA interference inhibiting rat ovarian androgen biosynthesis by depressing 17alpha-hydroxylase/17, 20-lyase activity in vivo.

BACKGROUND: 17alpha-hydroxylase/17, 20-lyase encoded by CYP17 is the key enzyme in androgen biosynthesis pathway. Previous studies demonstrated the accentuation of the enzyme in patients with polycystic ovary syndrome (PCOS) was the most important mechanism of androgen excess. We chose CYP17 as the therapeutic target, trying to suppress the activity of 17alpha-hydroxylase/17, 20-lyase and inhibit androgen biosynthesis by silencing the expression of CYP17 in the rat ovary. METHODS: Three CYP17-targeting and one negative control oligonucleotides were designed and used in the present study. The silence efficiency of lentivirus shRNA was assessed by qRT-PCR, Western blotting and hormone assay. After subcapsular injection of lentivirus shRNA in rat ovary, the delivery efficiency was evaluated by GFP fluorescence and qPCR. Total RNA was extracted from rat ovary for CYP17 mRNA determination and rat serum was collected for hormone measurement. RESULTS: In total, three CYP17-targeting lentivirus shRNAs were synthesized. The results showed that all of them had a silencing effect on CYP17 mRNA and protein. Moreover, androstenedione secreted by rat theca interstitial cells (TIC) in the RNAi group declined significantly compared with that in the control group. Two weeks after rat ovarian subcapsular injection of chosen CYP17 shRNA, the GFP fluorescence of frozen ovarian sections could be seen clearly under fluorescence microscope. It also showed that the GFP DNA level increased significantly, and its relative expression level was 7.42 times higher than that in the control group. Simultaneously, shRNA treatment significantly decreased CYP17 mRNA and protein levels at 61% and 54%, respectively. Hormone assay showed that all the levels of androstenedione, 17-hydroxyprogesterone and testosterone declined to a certain degree, but progesterone levels declined significantly. CONCLUSION: The present study proves for the first time that ovarian androgen biosynthesis can be inhibited by silencing CYP17 expression. It may provide a novel strategy for therapy of hyperandrogenism diseases, and also set an example for the use of RNAi technology in endocrine diseases.

[Variance of serum prolactin in controlled ovarian stimulation].

OBJECTIVE: To investigate the variance of peripheral blood prolactin (PRL) in controlled ovarian stimulation. METHODS: Seventy-two patients, with totally 106 cycles receiving a long protocol of gonadotropin-releasing hormone agonist combined with gonadotropin (Gn) were randomly enrolled in this retrospective study. During controlled ovarian stimulation, peripheral blood hormones were measured by chemiluminescent microparticle immunoassay. RESULTS: Prolactin was positively correlated with estradiol (r = 0.5897, P < 0.01) while there was no significant correlation between luteinizing hormone and PRL Progesterone had a positive relation with prolactin (r = 0.1412, P < 0.01). CONCLUSIONS: During controlled ovarian stimulation, prolactin secretion is not affected by Gn but may be stimulated by estradiol. Progesterone has a positive relation with prolactin.