Granulose cells follicle-stimulating hormone receptor (FSH-r) expression and its correlation to the total recombinant fsh (rFSH) in controlled ovarian hyperstimulation

Background: Follicle-stimulating hormone (FSH) plays a major role during folliculogenesis. The major gonadotropin used for a controlled ovarian hyperstimulation (COH) in assisted reproductive technology (ART) is recombinant Follicle-stimulating hormone (rFSH). The FSH action is mediated by its specific receptor (FSHR) expressed in granulosa cells. This study was conducted to show the relationship between FSHR expression with the rFSH dosages used in COH. Method: This study was done on 27 women (20 endometriosis patients and 7 non-endometriosis) who underwent In Vitro Fertilization (IVF) cycle in Yasmin Clinic of Ciptomangunkusumo Hospital and IA-IVF Daya Medika in Jakarta between January to June of 2016. The study was approved by the medical ethics committee of Faculty of Medicine, Universitas Indonesia. Informed consent was obtained from all the study participants. Granulose cells collected during oocyte retrieval were preserved using RNAlater® QIAGEN and evaluated by real-time PCR. Statistical analysis was done using a Pearson Correlation and Linear Regression methods. Results: The result shows there is no significant correlation between level of FSHR expression and total dosage of rFSH (r = 0.08, p > 0.05) of 27 women. We saw the same result when we observed correlation between FSHR expression with total dosage rFSH in endometriosis group (r = 0.05, P > 0.05) and non-endometriosis group (r = 0.609, p > 0.05). A simple linear regression was calculated to predict granulose cells FSHR expression based on total dosage of recombinant FSH. A regression equation was found (F(1,25) = 0.162, p <0.691), with r² = 0.006. Granulosa cells FSHR expression increased by 27.8 for each IU of total dosage of recombinant FSH. Conclusion: This study shows a weak correlation between granulosa cells FSHR expression and total dosage of recombinant FSH.