A comparative study of the expression of aromatase CYP19A1 and ERβ receptor in granulosa cells under different ovulation induction protocols:PPOS versus long protocol
TAN Xiao-fang
LIU Lin
MA Wei-wei
LI Hao
DING Jia-yi
Abstract：Objective To investigate the impact of the PPOS(progestin-primed ovarian stimulation)protocol on the mRNA and protein expression levels of aromatase CYP19A1 and ERβ receptor in granulosa cells compared to the conventional long protocol in patients with repeated implantation failure(RIF)experiencing low LH levels during in vitro fertilization-embryo transfer(IVF-ET)procedures.Methods A total of 36 RIF patients who underwent IVF-ET at the Reproductive Medicine Center of the Affiliated Maternity and Child Health Hospital of Nantong University from January 2020 to January 2022 were enrolled in the study.In the first cycle,the long protocol was used,and in the second cycle,the PPOS protocol was adopted.Granulosa cells from follicular fluid were collected from both protocols for the analysis of mRNA and protein expression levels of CYP19A1 and ERβ receptors.Clinical and laboratory parameters were compared between the two protocols for a self-controlled analysis to investigate the impact on granulosa cell development.Results The comparison of the average number of retrieved oocytes and mature oocytes showed no statistically significant differ-ences between the PPOS and long protocols(P＞0.05).However,the PPOS protocol demonstrated significantly higher LH levels on the trigger day,normal fertilization(2PN)numbers,normal fertilization rates,and high-quality embryo rates compared to the long protocol(P＜0.05).The mRNA expression levels of CYP19A1 and ERβ receptors in the PPOS group were significantly higher than those in the control group(P＜0.001).Consistent with the mRNA expression results,the protein expression levels of CYP19A1 and ERβ receptors in the PPOS group were also significantly higher than those in the control group(P＜0.05).Conclusion In RIF patients with low LH levels during the ovulation induction process in the first cycle using the long protocol,switching to the PPOS protocol in the second cycle resulted in a signifi-cant increase in LH levels on the trigger day.Simultaneously,mRNA and protein levels of ERβ and CYP19A1 in granulo-sa cells were significantly higher in the PPOS group.The use of the PPOS protocol improved LH levels,enhanced oocyte quality,and subsequently increased embryo quality.
Keywords：progestinovulation stimulationgranulosa cellin vitro fertilization-embryo transfer
Publication Date：2024-04-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 494-498 )