Notably, the poor responders who benefit from co treatment with rFSH and rLH usually also exhibit extremely low serum AMH levels. The two cell two gonadotropin theory posits that ovarian theca cells stimulated by LH produce androgens, which are then converted by granulosa cells into estrogens under FSH stimulation. However, the action of LH on follicular contain development is unlikely to be limited to providing an an drogen substrate for aromatization. In fact, LH also dir ect stimulates and modulates folliculogenesis. However, the efficacy of rLH in the follicular fluid micro environment and on luteinized granulosa cells has been less thoroughly assessed, and studies focusing on the interaction between LH, androgenAR and AMHSOX9 in granulosa cells are limited.

Our aim in this study Inhibitors,Modulators,Libraries was to examine whether rLH therapy affects the gene expression profiles of the androgenAR or AMH SOX9 endocrine and paracrine hormonal signaling pathways in human luteinized granulosa cells. We measured the expression levels of the luteinizing Inhibitors,Modulators,Libraries hormone receptor, AR, AR coactivators, SOX9, and AMH in granulosa cells collected from IVFICSI patients on the gonadotropin releasing hormone agonist protocol Inhibitors,Modulators,Libraries for ovarian stimulation, with or with out rLH co treatment with rFSH. In addition, we treated the human granulosa cell line HO 23 Inhibitors,Modulators,Libraries with rLH or androgen in vitro to investigate whether the gene ex pression profiles of the AR and AMH pathways were regulated by both LH and androgen. Methods COH Protocol 539 Patients undergoing their first ART treatment with a long COH protocol were enrolled in the study.

This study was approved by the Ethics Committee of Chang Gung Memorial Hospital. Approval from the institu tional review board was obtained for the analysis of this series. The study included patients Inhibitors,Modulators,Libraries who underwent IVFintracytoplasmic sperm injection in our institution between March 1, 2004 and September 30, 2006. Within this study period, 35 patients received rLH supplementation cycles 6 2 patients with previous intrauterine insemination poor response history 7 patients with age 35 years old 10 patients with mid follicular serum estradiol 100 pgmL or LH 0. 5mIUmL 2 patients with poor follicular growth rate in the mid follicular phase 1 patient with deep infiltrating endometriosis his tory and 1 patient due to obesity.

To match appropriate candidates to compare outcome efficiency, a 2 1 individ ual matching case control design was used to recruit 70 patients who did not receive rLH supplementation cycles but matched the demographic characteristics of the 35 patients receiving rLH therapy. At that time, it has been suggested that recombinant www.selleckchem.com/products/Belinostat.html LH can be used in a group of unselected IVF patients. All patients provided informed consent for their participa tion in the molecular investigation. The COH procedure was followed by the standard down regulation protocol, as published previously.