由垂体前叶分泌,生长激素(GH)是一种在调节细胞生长中起关键作用的肽,发展,和多个目标组织中的代谢。研究表明,GH及其功能受体也在女性生殖系统中表达,包括卵巢和子宫.实验数据表明,GH和胰岛素样生长因子1(IGF-1,由GH活性诱导)信号在直接控制多种生殖功能中的推定作用。包括原始卵泡的激活,卵泡发生,卵巢类固醇生成,卵母细胞成熟,和胚胎植入。此外,GH通过上调促性腺激素受体(卵泡刺激素受体和黄体生成素受体)的表达来增强颗粒细胞对促性腺激素的反应性。表明该卵巢调节因子与内分泌信号系统之间的串扰。值得注意的是,GH的自然基因突变和与年龄相关的GH水平下降可能对女性生殖功能产生不利影响,导致几种生殖疾病,比如卵巢储备减少,辅助生殖技术(ART)期间卵巢反应不良,植入失败。使用临床样本的关联研究表明,成熟的GH肽存在于人卵泡液中,该液体中GH的浓度与卵母细胞质量以及随后的胚胎形态和卵裂率呈正相关。此外,从动物实验和人体样本中获得的结果表明,在体外培养系统中补充GH会增加类固醇激素的产生,防止细胞凋亡,并提高卵母细胞成熟和胚胎质量。子宫内膜是另一个GH靶部位,由于GH通过促进植入过程促进子宫内膜容受性和妊娠,和GH受体在小鼠中的靶向消耗导致更少的子宫植入部位。虽然仍有争议,在卵巢刺激期间给予GH缓解了与年龄相关的ART效率下降,包括检索到的卵母细胞数量,受精率,胚胎质量,植入率,怀孕率,和活产率,尤其是卵巢反应差和反复植入失败的患者。
Secreted by the anterior pituitary gland, growth hormone (GH) is a peptide that plays a critical role in regulating cell growth, development, and metabolism in multiple targeted tissues. Studies have shown that GH and its functional receptor are also expressed in the female reproductive system, including the ovaries and uterus. The experimental data suggest putative roles for GH and insulin-like growth factor 1 (IGF-1, induced by GH activity) signaling in the direct control of multiple reproductive functions, including activation of primordial follicles, folliculogenesis, ovarian steroidogenesis, oocyte maturation, and embryo implantation. In addition, GH enhances granulosa cell responsiveness to gonadotropin by upregulating the expression of gonadotropin receptors (follicle-stimulating hormone receptor and luteinizing hormone receptor), indicating crosstalk between this ovarian regulator and the endocrine signaling system. Notably, natural gene mutation of GH and the age-related decline in GH levels may have a detrimental effect on female reproductive function, leading to several reproductive pathologies, such as diminished ovarian reserve, poor ovarian response during assisted reproductive technology (ART), and implantation failure. Association studies using clinical samples showed that mature GH peptide is present in human follicular fluid, and the concentration of GH in this fluid is positively correlated with oocyte quality and the subsequent embryo morphology and cleavage rate. Furthermore, the results obtained from animal experiments and human samples indicate that supplementation with GH in the in vitro culture system increases steroid hormone production, prevents cell apoptosis, and enhances oocyte maturation and embryo quality. The uterine endometrium is another GH target site, as GH promotes endometrial receptivity and pregnancy by facilitating the implantation process, and the targeted depletion of GH receptors in mice results in fewer uterine implantation sites. Although still controversial, the administration of GH during ovarian stimulation alleviates age-related decreases in ART efficiency, including the number of oocytes retrieved, fertilization rate, embryo quality, implantation rate, pregnancy rate, and live birth rate, especially in patients with poor ovarian response and recurrent implantation failure.