O-26: Effects of Recombinant-LH Supplementation on The Proteomic Profile of Follicular Fluid from Poor Responder Patients: Focus on Follicular Growth Factors and Oocyte Maturity Markers

Background Poor and fragmentary data was available regarding the effects of recombinant-LH (r-LH) in in-vitro granulosa and theca cells of human origin. No data was available from in vivo studies regarding the effects of r-LH supplementation on SCF,EGF,ERK-1/2 and AKT-1 pathways in the follicular fluid of older-poor-responder women undergoing IVF cycle. Evidence from in-vitro and animal studies seems to confirm that r-LH, in addition increasing cAMP levels (involved in steroidogenesis), activates the ERK-1/2 (proliferation) and AKT-1 (anti-apoptotic) pathways. The aim of the study project is to understand if the r-LH supplementation during IVF (in-vitro-fertilization) cycles in poor responder patients may influence the pathways involved in follicular growth and oocyte maturity. To understand which follicular signaling pathways are influenced by r-LH supplementation and finally to understand if these factors may explain the clinical advantages of r-LH supplementation in older poor-responder-patients. MaterialsAndMethods We recruited 28 poor responder patients older than 42 years. All patients underwent COH (controlled-ovarian-hyperstimulation) using r-FSH 300 IU/ day (recombinant-FSH) alone in the first cycle (s-COH group) and using r-FSH (300 IU/day) with r-LH (150 IU/day) supplementation (ex-COH group) in the second cycle. We compared follicular concentrations of SCF, EGF, Erk 1-2, p-Erk 1-2, Akt-1 and p-Akt-1 between the two groups. Follicular levels of SCF, EGF, Erk 1-2, p-Erk-1/2, Akt-1, p-Akt-1 were detected using appropriate ELISA-Kit and reported in pg/mL, ng/ mL or Unit/mL, according to the manufacturer’s indications. Results Follicular levels (56 samples) of EGF, Erk 1-2, p- Erk-1/2, Akt-1, p-Akt-1 were significantly different between s-COH versus ex-COH, with the exception of SCF. In detail, mean value of EGF was 9.40 ± 2.92 vs. 11.75 ± 3.95 pg/mL (P