Влияние поддержки лютеиновой фазы агонистом гонадотропин-рилизинг-гормона на рецептивность эндометрия и исходы программы экстракорпорального оплодотворения

Савельева Е.М., Перминова С.Г., Демура Т.А., Стрельченко Д.А. Влияние поддержки лютеиновой фазы агонистом гонадотропин-рилизинг-гормона на рецептивность эндометрия и исходы программы экстракорпорального оплодотворения. Гинекология. 2016; 18 (3): 48–53.

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Savelyeva E.М., Perminova S.G., Demura T.A., Strelchenko D.A. Effect of luteal phase support gonadotropin–releasing hormone agonist on the endometrial
receptivity and outcomes of in vitro fertilization programs. Gynecology. 2016; 18 (3): 48–53.

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Аннотация

У пациенток с трубно-перитонеальным фактором бесплодия в окно имплантации выявлены сокращение зрелых пиноподий и экспрессии лейкемия-ингибирующего фактора, дисбаланс прогестероновых и эстрогеновых рецепторов в строме эндометрия, снижение экспрессии гонадотропин-рилизинг-гормона (ГнРГ), ГнРГ-рецептора и гена гомеобокса-10, что свидетельствует о нарушении рецептивности эндометрия и снижении его имплантационных свойств. Применение препаратов агониста ГнРГ для поддержки лютеиновой фазы оказывает благоприятный эффект на рецептивность эндометрия и клинические исходы программы экстракорпорального оплодотворения.

Ключевые слова: экстракорпоральное оплодотворение, поддержка лютеиновой фазы, агонист гонадотропин-рилизинг-гормона, микронизированный прогестерон, рецептивность эндометрия, гонадотропин-рилизинг-гормон, рецептор гонадотропин-рилизинг-гормона, HOXA10.

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Patients with tubal infertility in implantation window period show impaired endometrial receptivity with low implantation potention that is characterized by decrease in mature pinopodes level on endometrium,decreased expression of leukemia inhibitory factor, gonadotropin-releasing-hormone, gonadotropin-releasing-hormone receptors, HOXA10 gene in epithelium and stroma and disbalancein progesterone and estradiol receptors in stroma. The use of gonadotropin-releasing-hormone agonist for luteal phase support has a favorable impact on endometrial receptivity and clinical outcomes of in vitro fertilization programs.

Key words: in vitro fertilization, luteal phase support, gonadotropin-releasing-hormone agonist, micronized progesterone, endometrial receptivity, gonadotropin-releasing-hormone, gonadotropin-releasing-hormone receptors, HOXA10.

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Список литературы

1. Beckers NG, Macklon NS, Eijkemans MJ et al. Nonsupplemented luteal phase characteristics after the administration of recombinant human chorionic gonadotropin, recombinant luteinizing hormone, or gonadotropin-releasing hormone (GnRH) agonist to induce final oocyte maturation in vitro fertilization patients after ovarian stimulation with recombinant follicle-stimulating hormone and GnRH antagonist cotreatment. J Clin Endocrinol Metab 2003; 88: 4186–92.
2. Fauser BC, Devroey P. Reproductive biology and IVF: ovarian stimulation and luteal phase consequences. Trends Endocrinol Metab 2003; 14: 236–42.
3. Van der Linden M, Buckingham K, Farquhar C et al. Luteal phase support for assisted reproduction cycles (Review) Copyright© 2015 The Cochrane Collaboration. Published by JohnWiley& Sons, Ltd.
4. Van der Linden M, Buckingham K, Farquhar C et al. Editorial Group: Cochrane Menstrual Disorders and Subfertility Group Published Online: 5 oct 2011. Assessed as up-to-date: 25 may 2011.
5. Gulsah Aynaoglu Yıldıza, Yavuz Emre Sukura, Can Ates, Rusen Aytaca. The addition of gonadotrophin releasing hormone agonist to routine luteal phase support in intracytoplasmic sperm injection and embryo transfer cycles: a randomized clinical trial. Eur J Obstet Gynecol Reprod Biol 2014; 182: 66–70.
6. Hsiao-Fan Kung, Ming-Jer Chen, Hwa-Fen Guua et al. Luteal phase support with decapeptyl improves pregnancy outcomes in intracytoplasmic sperm injection with higher basal follicle–stimulating hormone or lower mature oocytes. J Chin Med Assoc 2014; 77: 524–30.
7. Isik AZ, Caglar GS, Sozen E et al. Single-dose GnRH agonist administration in the luteal phase of GnRH antagonist cycles: a prospective randomized study. Reprod Biomed Online 2009; 19: 472–7.
8. Isikoglu M, Ozgur K, Oehninger S. Extension of GnRH agonist through the luteal phase to improve the outcome of intracytoplasmic sperm injection. Hum Reprod 2001; 16: 1671–5. J Reprod Med 2007; 52 (7): 639–44.
9. Mohamed A Aboulghar, Heba Marie, Yahia M Amin et al. GnRH agonist plus vaginal progesterone forluteal phase support in ICSI cycles: a randomized study. Reprod Biomed Online 2015; 30: 52–6.
10. Razieh DF, Maryam AR, Nasim T. Beneficial effect of luteal-phase gonadotropin-releasing hormone agonist administration on implantation rate after intracytoplasmic sperm injection. Taiwan J Obstet Gynecol 2009, 48: 245–8.
11. Tesarik J, Hazout A, Mendoza-Tesarik R et al. Beneficial effect of luteal-phase GnRH agonist administration on embryo implantation after ICSI in both GnRH agonist- and antagonist-treated ovarian stimulation cycles. Hum Reprod 2006; 21: 2572–9.
12. Zafardoust S, Jeddi-Tehrani M, Akhondi MM et al. Effect of Administration of Single Dose GnRH Agonist in Luteal Phase on Outcome of ICSI-ET Cycles in Women with Previous History of IVF/ICSI Failure: A Randomized Controlled Trial. J Reprod Infertil 2015; 16 (2): 96–101.
13. Pirard C, Donnez J, Loumaye E. GnRH agonist as novel luteal support: results of a randomized, parallel group, feasibility study using intranasal administration of buserelin. Hum Reprod 2005, 20: 1798–804.
14. Qublan H, Amarin Z, Al-Quda M et al. Luteal phase support with GnRH-a improves implantation and pregnancy rates in IVF cycles with endometrium of [less-than or equal to] 7 mm on day of egg retrieval. Hum Fertil 2008; 11 (1): 43–7.
15. Raga F, Casan EM, Kruessel JS et al. Quantitative gonadotropin-releasing hormone gene expression and immunohistochemical localization in human endometrium throughout the menstrual cycle. Biol Reprod 1998; 59: 661–9.
16. Raga F, Casan EM, Wen Y et al. Independent regulation of matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1 (TIMP-1), and TIMP-3 in human endometrial stromal cells by gonadotropin-releasing hormone: implications in early human implantation. J Clin Endocrinol Metab 1999; 84: 636–42.
17. Кондриков Н.И. Структурно-функциональные изменения эндометрия под воздействием стероидных гормонов. Журн. практического гинеколога. 1999; 1 (1): 12–9. / Kondrikov N.I. Strukturno-funktsional'nye izmeneniia endometriia pod vozdeistviem steroidnykh gormonov. Zhurn. prakticheskogo ginekologa. 1999; 1 (1): 12–9. [in Russian]
18. Vitielle D. HOX Genes in Implantation. Seminars Reprod Med 2007; 25: 431–6.

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1. Beckers NG, Macklon NS, Eijkemans MJ et al. Nonsupplemented luteal phase characteristics after the administration of recombinant human chorionic gonadotropin, recombinant luteinizing hormone, or gonadotropin-releasing hormone (GnRH) agonist to induce final oocyte maturation in vitro fertilization patients after ovarian stimulation with recombinant follicle-stimulating hormone and GnRH antagonist cotreatment. J Clin Endocrinol Metab 2003; 88: 4186–92.
2. Fauser BC, Devroey P. Reproductive biology and IVF: ovarian stimulation and luteal phase consequences. Trends Endocrinol Metab 2003; 14: 236–42.
3. Van der Linden M, Buckingham K, Farquhar C et al. Luteal phase support for assisted reproduction cycles (Review) Copyright© 2015 The Cochrane Collaboration. Published by JohnWiley& Sons, Ltd.
4. Van der Linden M, Buckingham K, Farquhar C et al. Editorial Group: Cochrane Menstrual Disorders and Subfertility Group Published Online: 5 oct 2011. Assessed as up-to-date: 25 may 2011.
5. Gulsah Aynaoglu Yıldıza, Yavuz Emre Sukura, Can Ates, Rusen Aytaca. The addition of gonadotrophin releasing hormone agonist to routine luteal phase support in intracytoplasmic sperm injection and embryo transfer cycles: a randomized clinical trial. Eur J Obstet Gynecol Reprod Biol 2014; 182: 66–70.
6. Hsiao-Fan Kung, Ming-Jer Chen, Hwa-Fen Guua et al. Luteal phase support with decapeptyl improves pregnancy outcomes in intracytoplasmic sperm injection with higher basal follicle–stimulating hormone or lower mature oocytes. J Chin Med Assoc 2014; 77: 524–30.
7. Isik AZ, Caglar GS, Sozen E et al. Single-dose GnRH agonist administration in the luteal phase of GnRH antagonist cycles: a prospective randomized study. Reprod Biomed Online 2009; 19: 472–7.
8. Isikoglu M, Ozgur K, Oehninger S. Extension of GnRH agonist through the luteal phase to improve the outcome of intracytoplasmic sperm injection. Hum Reprod 2001; 16: 1671–5. J Reprod Med 2007; 52 (7): 639–44.
9. Mohamed A Aboulghar, Heba Marie, Yahia M Amin et al. GnRH agonist plus vaginal progesterone forluteal phase support in ICSI cycles: a randomized study. Reprod Biomed Online 2015; 30: 52–6.
10. Razieh DF, Maryam AR, Nasim T. Beneficial effect of luteal-phase gonadotropin-releasing hormone agonist administration on implantation rate after intracytoplasmic sperm injection. Taiwan J Obstet Gynecol 2009, 48: 245–8.
11. Tesarik J, Hazout A, Mendoza-Tesarik R et al. Beneficial effect of luteal-phase GnRH agonist administration on embryo implantation after ICSI in both GnRH agonist- and antagonist-treated ovarian stimulation cycles. Hum Reprod 2006; 21: 2572–9.
12. Zafardoust S, Jeddi-Tehrani M, Akhondi MM et al. Effect of Administration of Single Dose GnRH Agonist in Luteal Phase on Outcome of ICSI-ET Cycles in Women with Previous History of IVF/ICSI Failure: A Randomized Controlled Trial. J Reprod Infertil 2015; 16 (2): 96–101.
13. Pirard C, Donnez J, Loumaye E. GnRH agonist as novel luteal support: results of a randomized, parallel group, feasibility study using intranasal administration of buserelin. Hum Reprod 2005, 20: 1798–804.
14. Qublan H, Amarin Z, Al-Quda M et al. Luteal phase support with GnRH-a improves implantation and pregnancy rates in IVF cycles with endometrium of [less-than or equal to] 7 mm on day of egg retrieval. Hum Fertil 2008; 11 (1): 43–7.
15. Raga F, Casan EM, Kruessel JS et al. Quantitative gonadotropin-releasing hormone gene expression and immunohistochemical localization in human endometrium throughout the menstrual cycle. Biol Reprod 1998; 59: 661–9.
16. Raga F, Casan EM, Wen Y et al. Independent regulation of matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1 (TIMP-1), and TIMP-3 in human endometrial stromal cells by gonadotropin-releasing hormone: implications in early human implantation. J Clin Endocrinol Metab 1999; 84: 636–42.
17. Kondrikov N.I. Strukturno-funktsional'nye izmeneniia endometriia pod vozdeistviem steroidnykh gormonov. Zhurn. prakticheskogo ginekologa. 1999; 1 (1): 12–9. [in Russian]
18. Vitielle D. HOX Genes in Implantation. Seminars Reprod Med 2007; 25: 431–6.

Авторы

Е.М.Савельева1, С.Г.Перминова1, Т.А.Демура2, Д.А.Стрельченко1

1. ФГБУ Научный центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова Минздрава России. 117997, Россия, Москва, ул. Академика Опарина, д. 4;
2. ГБОУ ВПО Первый Московский государственный университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*perisvet@list.ru

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E.М.Savelyeva1, S.G.Perminova*1, T.A.Demura2, D.A.Strelchenko1

1. V.I.Kulakov Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Akademika Oparina, d. 4;
2. I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*perisvet@list.ru

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