Corpus Luteal Contribution to Maternal Pregnancy Physiology and Outcomes in ART

黄体对孕产妇妊娠生理学和 ART 结果的贡献

• 批准号: 8730697
• 负责人: Kirk P Conrad
• 金额: $ 122.26万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-27 至 2016-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8730697
• 关键词: Address; Age; Assisted Reproductive Technology; Biostatistics Core; Bone Marrow; Budgets; Cardiovascular system; Cerebrum; Clinical; Clinical Research; Comorbidity; Conceptions; Databases; Epidemiology; Exclusion Criteria; Florida; Future; Hormones; Human Resources; Investigation; Kidney; Knowledge; Maternal Age; Maternal Physiology; Metabolic; Morbidity - disease rate; Mothers; Outcome; Perinatal; Physiological; Physiological Adaptation; Physiology; Pregnancy; Pregnancy Outcome; Primates; Production; Protocols documentation; Published Comment; Recruitment Activity; Relaxation; Relaxin; Reproductive Physiology; Research; Role; Secondary to; Societies; Stem cells; Structure; Testing; Time; Translations; Universities; Vascular Diseases; Vasodilation; Woman; angiogenesis; base; clinical practice; corpus luteum; data management; design; egg; hypertensive heart disease; improved; insight; mortality; novel; older women; patient population; perinatal outcomes; preclinical study; programs; prospective; response; synergism

DESCRIPTION (provided by applicant): The overarcliing hypothesis of this Program Project is that many pregnancies conceived by ART (Assisted Reproductive Technology) begin in a state which is not physiological for the mother, secondary to the abnormal status of the corpus luteum and its production of relaxin or other hormones. Thus, the corpus luteum, maternal circulating relaxin and other corpus luteal hormones may be absent altogether, or there may be multiple corpora lutea, supraphysiological concentrations of relaxin and other corpus luteal hormones depending on the ART protocol. Whether naturally occuring or iatrogenically imposed, we propose that abnormal corpus luteal status compromises optimal maternal physiological adaptations to pregnancy, and consequently, predisposes to obstetrical complications and adverse perinatal outcomes. This hypothesis is founded upon tantalizing and provocative, yet compelling preliminary evidence from our preclinical and clinical studies. In Project I, we will comprehensively investigate for the first time, the maternal cardiovascular adaptations to ART pregnancies in the University of Florida CTSI. In Project II, a new and exciting maternal adaptation to pregnancy dealing with bone marrow derived progenitor cells will be explored in ART subjects, and in relation to maternal vasodilation, increases in arterial compliance, endothelial dependent relaxation and maternal angiogenesis. In Project III, we will interrogate whether the state of the corpus luteum correlates with increased obstetrical complications, and perinatal morbidity and mortality using the Society of Assisted Reproductive Technology (SART) database, and prospective analysis of the Stanford ART patient populations. These 3 Projects will be joined by 3 Cores: Administrative Core A, Data Management and Biostatistics Core B, and Analytical Core C. There are numerous intellectual and logistical interactions and potent synergisms among the component Projects and Cores.

描述（由申请人提供）：该计划项目的总体假设是，许多通过 ART（辅助生殖技术）受孕的妊娠开始时处于对母亲来说不符合生理的状态，继发于黄体及其生成的异常状态松弛素或其他激素。因此，黄体、母体循环松弛素和其他黄体激素可能完全不存在，或者可能存在多个黄体、松弛素和其他黄体激素的超生理浓度，具体取决于 ART 方案。无论是自然发生的还是医源性强加的，我们认为异常的黄体状态都会损害母亲对妊娠的最佳生理适应，因此容易出现产科并发症和不良的围产期结局。这一假设是建立在我们的临床前和临床研究中诱人且令人兴奋但令人信服的初步证据之上的。在项目 I 中，我们将首次全面调查佛罗里达大学 CTSI 中母亲心血管对 ART 妊娠的适应情况。在项目 II 中，将在 ART 受试者中探索一种新的、令人兴奋的母体对妊娠的适应，涉及骨髓来源的祖细胞，并且与母体血管舒张、动脉顺应性增加、内皮依赖性松弛和母体血管生成有关。在项目 III 中，我们将利用辅助生殖技术协会 (SART) 数据库以及对斯坦福 ART 患者群体的前瞻性分析，探讨黄体状态是否与产科并发症增加以及围产期发病率和死亡率相关。这 3 个项目将由 3 个核心组成：行政核心 A、数据管理和生物统计核心 B 以及分析核心 C。组成项目和核心之间存在大量的智力和后勤互动以及有效的协同作用。