Abstract:

Objective To investigate the effects of GnRH agonist (GnRH-a) on cell cycle and expression of anti-apoptosis protein cFLIP of ovarian granulosa cells in patients with endometriosis. Methods Forty-five women treated with in vitro fertilization and embryo transfer (IVF-ET) were selected, among whom 19 were patients with endometriosis and randomly assigned to GnRH-a treatment group (group A, n=11) and general long protocol group (group B, n=8). The other 26 women who were infertile due to tubal factors and treated with general long protocol were served as control group(group C). Granulosa cells were obtained from follicular fluid, cell cycle was analyzed by flow cytometry, and the expression of cFLIP protein in granulosa cells was detected by Western blotting. Results There was no significant difference in fertilization rates, clinical pregnancy rates, implantation rates and miscarriage rates among three groups (P>0.05). There was no significant difference in the percentage of G0/G1 phase cells among three groups (P>0.05). The percentage of S phase cells was significantly higher, that of G2/M phase cells was significantly lower, and that of apoptosis peak was significantly higher in group A and group B than those in group C (P<0.05). However, there was no significant difference in cell cycle between group A and goup B (P>0.05). The expression of cFLIP protein in ovarian granulosa cells in group C was significantly higher than that in group A and group B (P<0.05), while there was no significant difference between group A and group B (P>0.05). Conclusion The apoptosis of ovarian granulosa cells in patients with endometriosis increases, with abnormal cell cycle. Treatment with prolonged GnRH-a protocol may not improve the abnormal status of impaired cell cycle and lower expression of cFLIP.

Key words: gonadotropin-releasing hormone agonist, endometriosis, ovarian granulosa cells, cell cycle, cFLIP