Women with poor response to IVF have lowered circulating gonadotrophin surge-attenuating factor (GnSAF) bioactivity during spontaneous and stimulated cycles

F Martinez, P N Barri, B Coroleu, R Tur, T Sorsa-Leslie, W J Harris, N P Groome, P G Knight, P A Fowler

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Abstract

BACKGROUND: Up to 13% of IVF cancellations are due to poor responses during down-regulated cycles. Because premature luteinization occurs more frequently in older or 'poor responder' patients, defective production of gonadotrophin surge-attenuating factor (GnSAF) may be involved. METHODS: Nine women with normal previous IVF response (NORM) and 9 with previous poor IVF response (POOR) were monitored in a spontaneous cycle (blood samples: days 2, 7, 11, 15 and 20) and then stimulated with recombinant human FSH (rFSH) under GnRH agonist (blood samples: treatment days GnRH agonist + 2, GnRH agonist + 7, day of HCG administration and days HCG + 1 and HCG + 8). LH, FSH, estradiol, progesterone and inhibin-A and -B were assayed in individual samples while GnSAF bioactivity was determined in samples pooled according to day, cycle and IVF response. RESULTS: During spontaneous cycles LH, steroids and inhibins were similar between NORM and POOR women, FSH was elevated in POOR women (4.9 +/- 0.3 versus 6.7 +/- 0.6 mIU/l, P < 0.01) and GnSAF bioactivity was detectable on days 2, 7 and 11 in NORM women only. During IVF cycles inhibin-A and -B rose more markedly in NORM than POOR women. Similarly GnSAF production peaked on day GnRH agonist + 7 in NORM women, but on the day of HCG administration in POOR women. CONCLUSIONS: Defects in ovarian responsiveness to FSH include reduced GnSAF production. This suggests that GnSAF should be investigated as a marker of ovarian reserve once an immunoassay becomes available.

Original languageEnglish
Pages (from-to)634-640
Number of pages7
JournalHuman Reproduction Update
Volume17
Publication statusPublished - 2002

Keywords

  • FSH
  • GnSAF
  • ovulation induction
  • LH
  • spontaneous cycle
  • IN-VITRO FERTILIZATION
  • HUMAN MENOPAUSAL GONADOTROPINS
  • HUMAN MENSTRUAL-CYCLE
  • INHIBITING FACTOR
  • FOLLICULAR-FLUID
  • EMBRYO-TRANSFER
  • PREMATURE LUTEINIZATION
  • SERUM CONCENTRATIONS
  • LEUPROLIDE ACETATE
  • OVARIAN RESPONSES

Cite this

Martinez, F., Barri, P. N., Coroleu, B., Tur, R., Sorsa-Leslie, T., Harris, W. J., Groome, N. P., Knight, P. G., & Fowler, P. A. (2002). Women with poor response to IVF have lowered circulating gonadotrophin surge-attenuating factor (GnSAF) bioactivity during spontaneous and stimulated cycles. Human Reproduction Update, 17, 634-640.