Human Reproduction, Vol. 7, No. 5, pp. 592-596, 1992
© 1992 European Society of Human Reproduction and Embryology
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In-vitro progesterone production of human granulosaluteal cells: the impact of different stimulation protocols, poor ovarian response and polycystic ovarian syndrome
Department of Obstetrics and Gynaecology, University of Tübingen Pappelweg 1, D-7400 Tübingen, FRG
Correspondence: 1To whom correspondence should be addressed
Granulosa cells from 85 patients undergoing in-vitro fertilization were cultured to investigate the impact of different stimulation protocols on in-vitro steroid secretion. A luteinizing hormone-releasing hormone analogue (LHRHa) was used either in the long protocol (pituitary desensftization) or in the short, flare-up regime. The steroidogenesis of granulosa cell cultures was investigated under basal conditions as well as after stimulation with luteinizing hormone (LH). The results were compared to the secretory capacity of cells obtained after treatment with gonadotrophins only. No correlation was found between the preovulatory oestradiol peak and subsequent in-vitro progesterone production. Granulosaluteal cells from long protocol cycles exhibited lower progesterone production on day 2 after follicular aspiration. On days 3 and 4 there was no difference between the three stimulation protocols regarding either basal or stimulated progesterone secretion. Cells from poor responders produced significantly (P < 0.05) less basal progesterone during culture but they responded sufficiently to an LH stimulus. Granulosa cells from polycystic ovaries showed the lowest basal progesterone secretion (P < 0.01 versus control; however, a normal stimulated level was achieved by adding LH to the culture medium. It is concluded that long protocol LHRHa pretreatment affects the very early progesterone formation of granulosa-luteal cells. Based on these in-vitro results, both poor responders and patients with polycystic ovaries should be supported vigorously in the luteal phase.
Key words: granulosa cell culture/polycystic ovarian syndrome/poor responder/progesterone/stimulation protocol