Standard hCG vs. Double Trigger for Final Oocyte Maturation Results in Different Granulosa Cells Gene Expressions

Objective: To investigate the mRNA expression of reproduction related genes in granulosa cells (GCs) of patients triggered with hCG compared to patients triggered with GnRH agonist and hCG (Double trigger) for final oocyte maturation.

Design: GCs were obtained at the time of oocyte retrieval and gene expression was analyzed using quantitative real time PCR.

Settings: Referral center.

Patient(s): 15 women undergoing controlled ovarian hyperstimulation for IVF who received hCG for final follicular maturation and in a subsequent IVF cycle received double trigger.

Interventions: GCs collection.

Main Outcome Measure(s): The expression of genes related to OHSS, gap junction and epidermal like growth factor in GCs.

Results: The mRNA expressions of amphiregulin (2.1 vs. 1, arbitrary unit ) and epiregulin (2.5 vs. 1 arbitrary unit) were significantly higher in the double trigger group compared to the hCG group.

We found no difference in LHR and FSHR mRNA expressions between the two groups.

Moreover, while the mRNA expression of PEDF (Pigment epithelium-derived factor) (1.5 vs. 1, arbitrary unit) was significantly higher in the double trigger group, no in-between groups differences were observed in the expression of VEGF (vascular endothelial growth factor) and GnRH receptor.

The mRNA expression of conexin43 in cumulus cells (0.7 vs. 1, arbitrary unit) was significantly lower in the double trigger group compared to the hCG group.

Conclusion: Our findings suggest that the decreased expression of conexin43 and the increased expression of epiregulin and amphiregulin in the GCs from patients receiving the double trigger, may explain the suggested improved oocyte and embryo quality related to the double triggering group.