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Hum. Reprod. Advance Access published online on August 10, 2008
Human Reproduction, doi:10.1093/humrep/den299
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Effect of rising hCG levels on the human corpus luteum during early pregnancy

Ilkka Y. Järvelä1,3, Aimo Ruokonen2 and Aydin Tekay1

1 Department of Obstetrics and Gynecology, Oulu University Hospital, PO Box 5000, FIN-90014 Oulu, Finland 2 Department of Clinical Chemistry, Oulu University Hospital, FIN-90014 Oulu, Finland

3 Correspondence address. E-mail: ilkka.jarvela{at}oulu.fi

BACKGROUND: During early pregnancy, the most important task of the corpus luteum (CL) is to produce sufficient progesterone until the luteoplacental shift occurs. Progesterone production is closely related to the extensive vasculature surrounding and supplying the CL. The synthesis of both progesterone and factors controlling the vasculature in the CL is regulated by hCG, which is released initially at rising levels from the placenta. The primary aim of this research was to evaluate changes in the CL vasculature during early pregnancy.

METHODS: Twenty naturally conceived pregnancies were examined weekly from weeks 5 to 11. At each visit, blood samples were obtained to determine the concentrations of hCG, progesterone and 17-OH progesterone (17-OHP). The vasculature in the ovaries was assessed using three-dimensional power Doppler ultrasonography.

RESULTS: The vascular supply in the ovary containing the CL was greatest at week 5, and thereafter, declined continuously until week 11. The decrease in the vasculature correlated with the decrease in 17-OHP. Mean hCG levels reached a maximum at week 8, progesterone levels reached the nadir at week 7 and increased after that.

CONCLUSIONS: Vasculature in the CL appears to be created already by the fifth week of pregnancy and it does not enlarge despite rising hCG levels. The activity of the CL during pregnancy may be measured non-invasively by assessing its vasculature with three-dimensional ultrasonography.

Key words: estradiol/gestational sac/luteoplacental shift/pregnancy-associated plasma protein-A/placenta

Submitted on March 10, 2008; resubmitted on July 1, 2008; accepted on July 10, 2008.


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