Clinical and Molecular Effects of GnRH Agonist and Antagonist on The Cumulus Cells in The In Vitro Fertilization Cycle

Document Type : Original Article


1 Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Anatomical Sciences, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran


Gonadotropin-releasing hormone (GnRH) analogues have been extensively utilized in the ovarian s timulation
cycle for suppression of endogenous rapid enhancement of luteinizing hormone (LH surge). Exclusive properties
and functional mechanisms of GnRH analogues in in vitro fertilization (IVF) cycles are clearly described. This s tudy was
performed to evaluate clinical and molecular impacts of the GnRH agonis t and antagonis t protocols in IVF cycles. For
this purpose, gene expression of cumulus cells (CCs) as well as clinical and embryological parameters were evaluated
and compared between two groups (GnRH agonis t and antagonis t) during the IVF cycle.
Materials and Methods:
Twenty-one infertile individuals were enrolled in this s tudy. Subjects were
selected from two groups of GnRH agonis t (n=10) treated patients and GnRH antagonis t (n=11) treated individuals.
The defined clinical embryological parameters were compared between the two groups. Expression of BAX, BCL-2,
SURVIVIN, ALCAM, and VCAN genes were assessed in the CCs of the participants using the real-time polymerase
chain reaction (PCR) technique.
The mean number of cumulus oocyte complex (COC), percentage of metaphase II (MII) oocytes, grade A
embryo and clinical parameters did not show noticeable differences between the two groups. BAX gene expression in
the CCs of the group treated with GnRH agonis t was remarkably higher than those received GnRH antagonis t treatment
(P<0.001). The mRNA expression of BCL-2 and ALCM genes were considerably greater in the CCs of patients
who underwent antagonis t protocol in comparison to the group that received agonis t protocol (P<0.001).
Despite no considerable difference in the oocyte quality, embryo development, and clinical outcomes between
the group treated with GnRH agonis t and the one treated with antagonis t protocol, the GnRH antagonis t protocol
was slightly more favorable. However, further clinical s tudies using molecular assessments are required to elucidate
this controversial subject.


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