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Hum. Reprod. Advance Access originally published online on October 7, 2004
Human Reproduction 2004 19(11):2561-2568; doi:10.1093/humrep/deh487
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Human Reproduction vol. 19 no. 11 © European Society of Human Reproduction and Embryology 2004; all rights reserved

Characteristics of populations of granulosa cells from individual follicles in women undergoing ‘coasting’ during controlled ovarian stimulation (COS) for IVF

A.J. Tozer1,2, R.K. Iles1,3, E. Iammarrone1, R.A. Nica1, C.M.Y. Gillott2, Wen XuSong1, T. Al-Shawaf2 and J.G. Grudzinskas2,4,5

1 Williamson Laboratory, Barts and The London Hospitals, Queen Mary School of Medicine and Dentistry, Royal London Hospital, London E1 1BB, 2 Centre for Reproductive Medicine, Bart's and The London Hospital, Queen Mary School of Medicine and Dentistry, London EC1A 7BE, 3 Institute of Health Research, London Metropolitan University, Holloway Road, London and 4 The London Bridge Fertility, Gynaecology and Genetics Centre, London SE1 9RY, UK

5 To whom correspondence should be addressed. Email: ggrudzinskas{at}thebridgecentre.co.uk

BACKGROUND: The aim of this study was to evaluate the functional characteristics of granulosa cell populations of individual follicles of women undergoing controlled ovarian stimulation (COS) for IVF/ICSI in whom gonadotrophin had been withheld (‘coasted’) for the prevention of OHSS. METHODS: Follicular fluid and granulosa cells were isolated from 224 individual follicles in 41 women who had been coasted and from 257 individual follicles in 50 women who had a ‘normal’ response to COS. Cells were cultured at 10 000 cells per well, to evaluate progesterone secretion. Follicular fluid was assayed for progesterone and estradiol (E2). RESULTS: No significant differences were observed between the two groups with respect to granulosa cell number or follicular fluid progesterone and E2 and follicle size, the retrieval of an oocyte and the subsequent fertilization of the oocyte. However, the granulosa cells derived from the coasted group showed a higher rate of progesterone secretion per cell at 72 h which was sustained for longer. Differences were also seen at 72 and 120 h of culture with a loss of correlation between progesterone secretion and follicle diameter in the coasted group. CONCLUSIONS: Our findings suggest that coasting has an effect on the functional capacity of the granulosa cells and the duration of their function. It is likely that in women at risk of OHSS who are not coasted, the granulosa cells have the capacity to produce significantly more chemical mediators per cell and for a more prolonged period of time.

Key words: coasting/controlled ovarian stimulation/granulosa cells/progesterone


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