Роль активности лютеинизирующего гормона в контролируемой стимуляции яичников при вспомогательных репродуктивных технологиях

Активность лютеинизирующего гормона (ЛГ) играет ключевую роль в регуляции фолликулогенеза, овуляции и лютеинизации, определяя эффективность протоколов контролируемой стимуляции яичников (КСЯ) при вспомогательных репродуктивных технологиях (ВРТ). ЛГ обеспечивает синтез андрогенов в тека-клетках, которые служат субстратом для образования эстрогенов в клетках гранулезы под действием фолликулостимулирующего гормона (ФСГ), а также регулирует экспрессию рецепторов, мейотическое созревание ооцита и формирование лютеиновой фазы. Современные исследования показывают, что сбалансированное сочетание активности ФСГ и ЛГ необходимо для оптимального роста фолликулов и полноценного созревания яйцеклеток. Дефицит ЛГ приводит к снижению уровня эстрадиола, нарушению стероидогенеза и ухудшению показателей оплодотворения. Добавление препаратов с активностью ЛГ повышает эффективность лечения у женщин с гипогонадотропным гипогонадизмом, сниженным овариальным резервом, гипореактивностью яичников, а также у пациенток старшего репродуктивного возраста и при применении антагонистов гонадотропин-рилизинг-гормона. Использование человеческого менопаузального гонадотропина и его высокоочищенной формы, а также рекомбинантного ЛГ способствует улучшению гормонального профиля, повышению качества ооцитов и эмбрионов, а также снижению риска синдрома гиперстимуляции яичников. Включение активности ЛГ в схемы КСЯ обеспечивает более физиологичное созревание фолликулов и сбалансированный стероидный ответ. Оптимизация дозировки и сроков введения ЛГ, а также персонализация терапии с учетом возраста, овариального резерва и генетических особенностей пациентки позволяют повысить эффективность ВРТ, улучшить исходы лечения и обеспечить более безопасный и предсказуемый репродуктивный результат.

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