GnRH Agonist vs. hCG for Triggering of Ovulation - Differential Effects on Gene Expression in Human Granulosa Cells

Objective: To investigate the mRNA expression of genes related to steroidogenesis and OHSS in granulosa cells (GCs) of patients triggered with GnRH agonist compared to patients triggered with hCG. Design: Mural GCs were obtained at the time of oocyte retrieval and gene expression was analyzed using quantitative real time RT-PCR. Settings: Single center, case control study. Patient(s): 24 women who were treated with GnRH agonist or hCG for triggering of ovulation. Interventions: GC collection. Main Outcome Measure(s): The expression of genes related to steroidogenesis and OHSS in mural GCs Results: The fertilization rate was similar in the two groups. The mRNA expression of CYP19A1 (0.50 vs 1, arbitrary unit), CYP11A1 (0.6 vs. 1) and 3 beta hydroxysteroid-dehydrogenase (0.39 vs 1) was significantly lower in the GnRH group. The expression of VEGF (0.74 vs. 1) and inhibin beta B (0.38 vs 1) was lower in the GnRH analog triggered group. Conclusion: Expression of genes related to steroidogenesis is lower at the time of oocyte retrieval in patients triggered with GnRH agonist. The decreased expression of VEGF and inhibin b B in the GnRH agonist group can explain the mechanism of early OHSS prevention.