Médecine de la Reproduction


Polymorphism and ovarian response Volume 15, issue 3, Juillet-Août-Septembre 2013

Laboratoire d’Histologie, Embryologie, Biologie de la Reproduction, Cytogénétique et Génétique Médicale, CHI de Poissy St Germain, Poissy, France ; EA 2493, UFR des Sciences de la Santé, UVSQ, Montigny le Bretonneux, France

Assisted reproduction technology (ART) has solved many problems of infertility. The success of in vitro fecundation depends largely on the effectiveness of ovarian stimulation, which requires injections of gonadotropins to induce folliculogenesis. However, there is a high variability of individual responses to the ovarian stimulation. So the prediction of ovarian response to gonadotropins represents one of the major challenges of IVF. While, many predictive factors influencing the results of ovarian stimulation have been proposed (such as age, ovarian reserve), the search for new factors is still valid. More recently, pharmacogenetics has shown the role of genetic factors in the prediction of ovarian response. Our work has focused on the study of the impact of genetic polymorphisms on the ovarian response. Of the 13 genetic polymorphisms analyzed, previously described above to have an impact on ART outcome, only 4-FSHR Asn680Ser, p53-Arg72Pro, ESR2 +1730- G/A and AMH-Ile49Ser, have been shown associated with a variation on the number of mature oocytes. These results support an adjusted gonadotropin administration on the basis of the genetic component of each patient. The ultimate goal is to better individualize the initial dose of FSH to avoid insufficient ovarian response or ovarian hyperstimulation syndrom.