Is there a difference in the function of granulosa-luteal cells in patients undergoing in-vitro fertilization either with gonadotrophin-releasing hormone agonist or gonadotrophin-releasing hormone antagonist?

Gonadotrophin-releasing hormone (GnRH) regulates gonadotrophin release. It has been shown that GnRH may have a direct effect on the ovary, as the addi tion of GnRH to granulosa cell cultures inhibits the production of progeste rone and oestradiol, Specific GnRH receptors have been found to be present in rat and human granulosa cells. Desensitization of the pituitary by GnRH agonist has become common in in-vitro fertilization (IVF) treatment, usuall y by a long protocol of 2-3 weeks. With the introduction of GnRH antagonist s, which produce an immediate blockage of the GnRH receptors, a much shorte r exposure is needed of 3-6 days. The aim of this study was to evaluate the effect of a GnRH agonist (buserelin) and a GnRH antagonist (cetrorelix) on the function of granulosa cells cultured in vitro from IVF patients. Women were treated by IVF randomized either to have buserelin nasal spray from t he luteal phase in the previous cycle or cetrorelix from day 6 of the cycle . Both groups had ovarian stimulation with human menopausal gonadotrophin ( HMG) 150 IU daily, i.e, HCG was administered when the follicles were larger than 17 mm, and aspirated 36 h later. Granulosa cells, separated and washe d from large follicles containing ova, were pooled. After 48 h of pre-incub ation, the granulosa cells were cultured for 4 days in medium with either a dded testosterone or cAMP with or without HCG, with change of medium after 2 days. The progesterone and oestradiol concentrations in the culture mediu m were measured by immunological assay, and cellular protein was measured b y microprotein assay. The results showed that granulosa cells from women tr eated with GnRH antagonist (cetrorelix) responded earlier to the in-vitro h ormone stimulation in terms of progesterone accumulation than women treated with the GnRH agonist (buserelin), This may have been due to difference in time of exposure to the analogue. The results may indicate that the luteal function is less impaired in GnRH antagonist treatment than in GnRH agonis t treatment.