rFSH in medically assisted procreation: Evidence for ovarian follicular hyperplasia and interest of mass spectrometry to measure 17-hydroxyprogesterone and Δ4-androstenedione in serum

MOLECULAR AND CELLULAR ENDOCRINOLOGY

卷:450

Article

Menet, M. C.^1,2  Hebert-Schuster, M. L.^2,3  Lahlou, N.¹  Marcellin, L.⁴  Leguy, M. C.¹  Gayet, V.⁴  Guibourdenche, J.^1,2 

[1] CHU Cochin, AP HP, Dept Biol Endocrinol, Paris, France

[2] Univ Paris 05, Fac Pharm, Paris, France

[3] CHU Cochin, AP HP, Dept Automated Biol, Paris, France

[4] CHU Cochin, AP HP, Dept Reprod Med, Paris, France

关键词: Procreation;    rFSH;    Ovary;    Serum;    Steroids;    Mass spectrometry;   

DOI  :  10.1016/j.mce.2017.04.024

来源: Elsevier

【 摘 要 】

Ovarian monitoring requires the determination of serum estradiol and progesterone levels. We investigated whole follicular steroidogenesis under rFSH in medically assisted procreation (MAP: 26 IVF, 24 ICSI) compared to 11 controls (IIJI). Estrone, estradiol, Delta 4-androstenedione, testosterone, progesterone and 17-hydroxyprogesterone were measured by immunoassay and mass spectrometry except for estrogens. At the start of a spontaneous or induced cycle, steroids levels fluctuated within normal ranges: estradiol (314-585 pmol/L), estrone (165-379 pmol/L) testosterone (1.3-1.6 nmol/L), Delta 4androstenedione (4.5-5.6 nmol/L), 17-hydroxyprogesterone (2.1-2.2 nmol/L) and progesterone (1.8-1.9 nmol/L). 17-hydroxyprogesterone, Delta 4-androstenedione and estradiol predominated. Then estradiol and oestrone levels rise, but less markedly for oestrone in IUI. In MAP, rFSH injections induce a sharp increase in estrogens associated with a rise in 17-hydroxyprogesterone and Delta 4-androstenedione levels, disrupting oestrogen/androgen ratios. rFSH stimulation induces an ovarian hyperplasia and Delta 4pathway which could become abnormal. Determining 17-hydroxyprogesterone and Delta 4-androstenedione levels with LC-MS/MS may therefore be useful in managing recurrent MAP failures. (C) 2017 Elsevier B.V. All rights reserved.

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