L'apoptose des cellules folliculaires : son implication dans les protocoles de stimulation ovarienne

Atresia, a degenerative process through which many follicles are removed from the grown pool of follicles involves apoptotic changes in the follicular cells. This review analyses the endocrine regulation of apoptotic cell death in ovarian follicle. FSH is the major survival factor for preovulatory follicle but follicle integrity, in vitro, was necessary to its action on granulosa cell. The role of LH is more ambivalent. FSH and LH exert their activity via activation of the cAMP signal. High levels of intracellular cAMP could enhance steroidogenesis and in the same time induce apoptosis in granulosa cells. Moreover, no correlation between steroidogenesis and apoptosis can be established. During ovarian stimulation in IVF protocol, the use of LH, of coasting and of GnRH agonists and antagonists could be deleterious in follicle survival.