Polymorphisms of anti-mullerian hormone receptor gene in infertile women and its correlation with controlled ovarian hyperestimulation

• Grant number: 13/06989-4
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: June 01, 2013
• End date: May 31, 2014
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Bianca Alves Vieira Bianco
• Grantee: Guilherme George Gastaldo
• Host Institution: Faculdade de Medicina do ABC (FMABC). Organização Social de Saúde. Fundação do ABC. Santo André , SP, Brazil

Abstract

Infertility affects about 20% of couples of reproductive age. The study of polymorphisms in genes that regulate the female reproductive function may help clarify the mechanisms responsible for gonadal function and fertility in humans.In assisted human reproduction, response to controlled ovarian hyperstimulation is variable and difficult to predict. In ovulatory young women undergoing in vitro fertilization (IVF), the stimulation protocol standard can result in both satisfactory answer, as in inadequate response which requires dose adjustment of FSH or ovarian hyperstimulation syndrome, a serious and potentially fatal complication IVF. Identifying patients with potential to develop hyper-response or inadequate response to standard treatment would greatly aid clinical. Various parameters have been postulated as predictors of ovarian response. The level of basal FSH on the third day of the cycle seems to have the best predictive ability, but a significant variability between individuals from cycle to cycle has been observed. The anti-müleriano hormone (AMH) is also involved in the regulation of follicular growth. Studies in knockout mice for the gene AMH demonstrated that in the absence of the hormone, the follicles are recruited at a faster rate and are more sensitive to FSH, suggesting that this hormone may inhibit initiation of primordial follicle growth and growth induced by FSH. Furthermore, studies in normo-ovulatory women have demonstrated association of AMH gene polymorphisms and its receptor AMHR2 with estradiol levels during the follicular phase of the menstrual cycle suggesting a role in regulating the sensitivity to FSH. Other authors also demonstrated that the basal level of AMH is correlated with the total dose of gonadotropin used, estradiol level and number of mature follicles on day of hCG, number of oocytes retrieved and pregnancy rates in women undergoing IVF. It was also suggested that the level of serum AMH could predict poor ovarian response (poor response) and ovarian hyperstimulation syndrome. Moreover, unlike FSH, although during the menstrual cycle AMH blood present mild fluctuations, it does not interfere with the interpretation of reserve. Thus, the AMH has currently been considered as a promising biomarker of ovarian status, and predict outcome of IVF, however, genetic variations in the gene encoding its receptor may influence hormonal function. Since the same polymorphism may have different patterns of association in different populations, is of great interest to characterize the actual relationship between gene polymorphism AMHR2, serum AMH and estradiol and results of controlled ovarian stimulation. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

PELUSO, CARLA; FONSECA, FERNANDO L. A.; GASTALDO, GUILHERME G.; CHRISTOFOLINI, DENISE M.; CORDTS, EMERSON BARCHI; BARBOSA, CAIO P.; BIANCO, BIANCA. AMH and AMHR2 Polymorphisms and AMH Serum Level Can Predict Assisted Reproduction Outcomes: A Cross-Sectional Study. CELLULAR PHYSIOLOGY AND BIOCHEMISTRY, v. 35, n. 4, p. 1401-1412, 2015. (13/06989-4, 11/08681-1, 11/15045-4, 14/06177-2)