移动抑制因子与体外受精-胚胎移植妊娠结局的相关性研究

目的:探讨人卵泡液中是否存在移动抑制因子(MIF)及其卵泡液和血液中的浓度对IVF-ET 妊娠结局的影响。方法:选择2004．08-2005．08行IVF-ET助孕的不孕妇女共37例,按妊娠结局分 为妊娠和非妊娠两组。收集取卵时的血液及卵泡液,定量酶联免疫法(ELISA)分别测定血及卵泡液 中MIF的浓度。并检测取卵前血中LH、P、E2值。结果:两组在获卵数、受精率、卵裂率、移植 胚胎数和激素水平无显著差异。妊娠组血清及卵泡液中MIF浓度分别为1．79±0．98 ng／ml和 22．97±10．62 ng／ml;非妊娠组分别为1．91±1．71 ng／ml和13．44±8．5ng/ml。两组卵泡液中 MIF浓度比较有显著差异(P<0．05);血清中浓度差异不明显(P>0．05)。卵泡液MIF浓度与优质胚 胎率呈正相关(r=0．3277,P<0．05),优质胚胎率在两组间差异显著(P<0．02)。结论:卵泡液中MIF可 能与卵泡发育及卵细胞质量有关,进而影响IVF-ET的结局。     

颗粒细胞凋亡率联合卵泡液孕激素预测IVF-ET结局

目的:探讨颗粒细胞凋亡率联合卵泡液中孕激素水平检测对体外受精-胚胎移植(IVF-ET)结局的预测价值。方法:选取2011年3月～2012年6月在我院行IVF-ET患者34例,分离收集颗粒细胞及卵泡液,33258荧光染料着色,记录颗粒细胞凋亡率,放射免疫法测定外周血及卵泡液中雌孕激素水平。比较妊娠组与非妊娠组的年龄、基础FSH、Gn用量及持续时间、卵泡数、取卵数、颗粒细胞凋亡率、雌孕激素水平、受精率。对颗粒细胞凋亡率及卵泡液雌孕激素水平进行相关性分析。以丘颗粒细胞凋亡率≤4‰,卵泡液孕激素浓度≤5.0ng/ml为阳性标准,进行联合检测。结果:妊娠组与非妊娠组的年龄、基础FSH、Gn用量及持续时间、卵泡数、取卵数、受精率及雌激素水平均无显著差异(P>0.05),颗粒细胞凋亡率、外周血及卵泡液中孕激素水平差异显著(P<0.05)。相关性分析发现,颗粒细胞凋亡率随孕激素含量升高而升高,但无显著差异(P>0.05)。联合检测阳性组妊娠率为75.8%。结论:颗粒细胞凋亡率、外周血及卵泡液孕激素水平与IVF-ET结局有关。联合检测能较好提高对妊娠结局的预测。     

血清抵抗素、C-反应蛋白及IL-6与PCOS的相关性研究

目的:探讨血清脂肪细胞因子抵抗素(resistin)、C-反应蛋白(CRP)、白细胞介素6(IL-6)水平与PCOS发生的相关性。方法:收集PCOS患者45例,再根据体质量指数(BMI)分为肥胖亚组(≥25kg/m2,22例)和非肥胖亚组(<25kg/m2,23例)。正常对照组45例,同样按BMI分为肥胖亚组(14例)和非肥胖亚组(31例)。空腹采集血清,采用酶联免疫分析法测定抵抗素、免疫比浊法测定CRP、放射免疫法测定IL-6,全自动生化分析仪测定血糖、血脂、化学发光法测定内分泌水平和血清胰岛素水平,同时测量身高、体质量、腰围、臀围,计算BMI和腰臀比值(WHR)。结果:与对照组非肥胖者相比,PCOS组肥胖、非肥胖者及对照组肥胖者抵抗素水平均显著增高(P<0.05);PCOS组和对照组肥胖者的CRP水平均高于对照组非肥胖者(P<0.05);PCOS组肥胖和非肥胖者的IL-6水平高于对照组非肥胖者(P<0.05)。抵抗素和CRP均与BMI、WHR、HOMA-IR呈显著正相关(P<0.05);IL-6与BMI、WHR有显著相关性,与HOMA-IR无相关性。结论:脂肪细胞因子抵抗素、CRP及IL-6参与PCOS患者肥胖和胰岛素抵抗的发生发展。     

PCOS患者卵泡液中内脂素、网膜素-1与IVF-ET的相关性研究

目的:探讨多囊卵巢综合征(PCOS)患者卵泡液中内脂素、网膜素-1及脂代谢成分在体外受精-胚胎移植(IVF-ET)中对卵泡生长、胚胎发育及妊娠结局的作用。方法:选取接受IVF-ET的患者130例,其中PCOS患者68例。将患者按BMI分组:正常体重PCOS组(41例),正常体重对照组(33例),超重PCOS组(27例),超重对照组(29例)。测定患者卵泡液中内脂素、网膜素-1及脂质(TC、TG、HDL、LDL)水平,分析其与IVF-ET结局的相关性。结果:PCOS患者卵泡液中内脂素浓度及TC浓度显著高于对照组;网膜素-1及HDL浓度显著低于对照组,差异均有统计学意义(P0.05)。按BMI分为亚组后,正常体重PCOS组的获卵数、MII卵数、卵泡液中内脂素、TC、TG、LDL浓度明显高于正常体重对照组,卵泡液中网膜素-1及HDL浓度明显低于正常体重对照组,差异均有统计学意义(P0.05)。超重PCOS组卵泡液中内脂素、TC、TG、LDL浓度明显高于超重对照组,卵泡液中网膜素-1及HDL浓度明显低于超重对照组,差异均有统计学意义(P0.05)。PCOS患者卵泡液中内脂素浓度与获卵数(r=0.546,P0.05)、优胚数(r=0.479,P0.05)呈正相关;卵泡液中网膜素浓度与BMI(r=-0.667,P0.05)、LDL(r=-0.498,P0.05)呈负相关,与卵泡液中HDL(r=0.582,P0.05)呈正相关。结论:PCOS患者卵泡液中内脂素水平升高及网膜素-1水平减低,提示内脂素及网膜素-1可能是诊断PCOS的一个潜在生物学指标。调节PCOS患者局部微环境中内脂素浓度可能会改善IVF助孕过程中部分COH结局。     

卵泡液中丙二醛水平对卵巢低反应患者体外受精-胚胎移植结局的影响

目的:探讨卵巢低反应(POR)患者取卵日卵泡液中丙二醛(MDA)水平对其体外受精-胚胎移植(IVF-ET)结局的影响。方法:回顾性分析2016年12月至2017年10月于河北医科大学第四医院生殖医学科行IVF-ET助孕的89例POR患者的临床资料。其中67例行胚胎移植(ET)患者中,未妊娠组43例,妊娠组24例。采用电化学发光法检测患者血清中基础黄体生成素(LH)及基础卵泡刺激素(FSH)水平,分光光度计检测患者卵泡液中MDA水平。结果:患者取卵日卵泡液中MDA水平在未妊娠组(19.04±4.64 U/ml)较妊娠组(13.59±6.19 U/ml)显著增高(P0.05),未妊娠组较妊娠组MⅡ卵率(71.33%vs 93.85%,P0.05)、正常受精率(46.93%vs 75.38%,P0.05)、优质胚胎率(34.88%vs 56.60%,P0.05)显著降低;MDA水平与年龄、体质量指数(BMI)呈明显正相关(r0,P0.05),与MⅡ卵率、正常受精率呈明显负相关(r0,P0.05)。结论:POR患者卵泡液中存在氧化应激状态,可能影响卵子质量,进而影响IVF-ET临床结局。     

二甲双胍联合未成熟卵体外培养成熟治疗多囊卵巢综合征的临床研究

目的探讨二甲双胍联合未成熟卵体外培养成熟(IVM)对氯米芬抵抗的多囊卵巢综合征(PCOS)的治疗效果。方法2003-10-2005-03将安徽医科大学第一附属医院56例氯米芬抵抗的PCOS患者随机分成两组,二甲双胍组(28例)给予二甲双胍500mg,每日2次,12周后进行34个IVM周期治疗;对照组(28例)直接行36个IVM周期治疗。比较两组获卵数、成熟率、受精率、优质胚胎形成率和妊娠率。荧光原位杂交(FISH)方法检测两组体外培养成熟的卵母细胞(MⅡ)13、16、18号染色体非整倍体情况。结果二甲双胍组和对照组每周期获未成熟卵数(12·35±6·29)个、(9·39±6·17)个,成熟率76·67%、70·41%,受精率69·57%、67·65%,卵裂率87·50%、89·44%,经比较差异均无显著性意义(P>0·05);两组优质胚胎形成率37·76%、24·31%,妊娠率38·24%、16·67%,经比较差异有显著性意义(P<0·05)。两组经体外培养成熟的卵细胞染色体非整倍体形成率差异无显著性意义(P>0·05)。结论对氯米芬抵抗的PCOS患者予以二甲双胍预治疗,可改善IVM的治疗效果,提高临床妊娠率。     

输卵管切除术对超排卵的影响

目的:探讨单侧输卵管切除,切除侧卵巢对超排卵的反应性。方法:以因输卵管妊娠行单侧输卵管切除后不孕接受IVF-ET治疗的患者45例共52个周期为研究组,并以同期因输卵管阻塞(无输卵管积水)不孕行IVF-ET治疗的患者875例共913个周期为对照,分析输卵管切除侧卵巢与对侧卵巢对超排卵的反应性。结果:①两组的促性腺激素(Gn)用量、用药天数、hCG日E_2水平、卵裂率、平均移植胚胎数、种植率、临床妊娠率、流产率、异位妊娠率差异无统计学意义(P>0.05)。但单侧输卵管切除组的获卵数减少,差异有统计学意义(P<0.05)。②研究组卵泡晚期(注射hCG日)两侧卵巢大小(分别为35.1±6.5mm、38.2±5.9 mm)有差异,P<0.05。取卵日两组卵泡数(个)分别为6.7±4.5、8.6±3.3(P<0.05),回收卵子数(个)分别为4.9±3.7、6.4±3.6,P<0.05。结论:单侧输卵管切除者切除侧卵巢在行超排卵时,其卵泡晚期(注射hCG日)卵巢较小,取卵日的卵泡数和回收卵子数明显减少,手术可能影响卵巢的血液供应和超排卵效果。     

汉族育龄多囊卵巢综合征患者的临床特征及分析

目的探讨汉族育龄妇女患多囊卵巢综合征(PCOS)的临床特征。方法根据欧洲人类生殖协会(ESHRE)和美国生殖医学协会(ASRM)提出的,将符合稀发排卵、高雄激素征象及卵巢多囊样表现3项中的2项即可诊断PCOS的标准(即ESHRE/ASRM诊断标准),采用分层整群随机抽样的方法,以问卷方式调查了山东省济南市某地区1027名育龄妇女,对检出的PCOS患者的临床表现、糖代谢特征进行分析;并与同期94名月经正常、已正常生育、无痤疮、无男性毛发分布及无卵巢多囊表现等的妇女(对照组)进行比较。结果(1)1027份调查问卷,收回有效问卷828份(即828名调查对象),问卷反馈率为80·62%。共检出PCOS患者85例,其中≤35岁患者为97·65%(83/85)。(2)同年龄段PCOS患者的月经周期较对照组长,反映临床高雄激素征象及程度的多毛F-G分数、睾酮、游离雄激素指数较对照组高,平均小卵泡数均较对照组多,血清性激素结合球蛋白较对照组降低,以上两者分别比较,差异均有统计学意义(P<0·01)。85例PCOS者的月经稀发程度、F-G分数、痤疮的发生情况、平均小卵泡数,随年龄增长呈现逐渐缩短或降低的趋势。(3)PCOS有不孕史患者的胰岛素抵抗指数为1·49±0·73,无不孕史患者为1·31±0·66,两者比较,差异有统计学意义(t=2·058;P<0·05)。PCOS肥胖患者的空腹胰岛素为(8·50±3·46)mU/L、空腹血糖为(5·70±2·27)mmol/L、胰岛素敏感指数为0·025±0·015;非肥胖患者空腹胰岛素为(5·45±0·54)mU/L、空腹血糖为(4·88±0·45)mmol/L,胰岛素敏感指数为0·044±0·026,以上两者比较,差异均有统计学意义(P<0·01,P<0·05)。结论按照ESHRE/ASRM诊断标准,35岁以下的育龄妇女是PCOS患者的主要群体;PCOS患者的稀发排卵、高雄激素征象、卵巢多囊表现等临床特征随年龄增长而变化;育龄期PCOS合并不孕、肥胖患者存在糖代谢改变,应重视其胰岛素抵抗现象。     

多囊卵巢综合征体外受精-胚胎移植妊娠结局及其影响因素分析

目的探讨多囊卵巢综合征(PCOS)不育患者行体外受精-胚胎移植(IVF-ET)的治疗效果及其影响因素。方法对2006年3月至2009年3月在广州医学院第三附属医院生殖医学中心行IVF的PCOS不孕患者作回顾性分析,观察组(A组)为PCOS不孕患者120例132周期,对照组(B组)为双侧输卵管梗阻不孕患者343例382周期,比较两组HCG日雌二醇(E2)、获卵数、受精率、优质胚胎数、种植率、临床妊娠率、活产率、周期取消率、卵巢过度刺激综合征(OHSS)发生率。PCOS患者根据BMI分为正常体重组(C组)及超重组(D组),比较两组妊娠结局。结果 A、B两组促性腺激素(Gn)用量及HCG日E2水平、每移植周期临床妊娠率、流产率、活产率差异无统计学意义(P0.05);A组与B组比较Gn用时较长,获卵数较多,受精率、卵裂率较高,优质胚胎数较多,种植率较低,OHSS发生率、周期取消率较高,差异有统计学意义(P0.05)。D组与C组比较,Gn总量较多、用时较长,HCG日E2峰值较低,获卵数、优质胚胎数较少,受精率较低,差异有统计学意义(P0.05);种植率较低,流产率、周期取消率及OHSS发生率较高,但差异无统计学意义(P0.05)。结论 IVF-ET是PC0S不孕患者的一种有效治疗方法,但应积极预防OHSS;肥胖及胰岛素抵抗可能对妊娠结局产生不良影响。     

骨形态蛋白(BMP)-15对子宫内膜异位症患者IVF结局影响的临床研究

目的:探索卵丘颗粒细胞早期凋亡和骨形态蛋白-15(bone morphogenetic protein-15,BMP-15)对子宫内膜异位症(EMs)患者IVF结局的影响。方法:行体外受精-胚胎移植(IVF-ET)的不孕患者,根据不孕指征分为EMs组及对照组。分别记录患者一般情况、获卵数、正常受精卵数、卵裂数、优质胚胎数、胚胎种植数和临床妊娠率。流式细胞仪测定所有对象卵丘颗粒细胞的早期凋亡率,Western blotting检测卵泡液中BMP-15蛋白的表达量。结果:获卵率、受精率、卵裂率、优质胚胎率差异无统计学意义(P>0.05);EMs组与对照组相比,获卵数分别为8.2±5.7个和12.0±5.8个,着床率分别为29.73%和47.31%,临床妊娠率分别43.37%和69.32%,差异均有统计学意义(P<0.05)。EMs组卵丘颗粒细胞的早期凋亡率为37.82±15.81%,对照组为8.85±5.58%,差异具有统计学意义(P<0.01)。卵泡液中BMP-15蛋白相对表达量EMs组为0.67±0.18,对照组0.94±0.33,差异有统计学意义(P<0.05)。结论:EMs患者IVF着床率及临床妊娠率降低,可能与卵母细胞分泌较少的BMP-15、颗粒细胞早期凋亡率增加,影响卵母细胞质量和胚胎的正常发育有关。     

Serum resistin levels in women with polycystic ovary syndrome

OBJECTIVE: To measure serum resistin levels in women with polycystic ovary syndrome (PCOS) and assess possible correlations of resistin to the hormonal and metabolic parameters of the syndrome. DESIGN: Clinical study. SETTING: University hospital. PATIENT(S): Ninety selected women were classified as follows: group I: 35 anovulatory women with PCOS (body mass index [BMI] >25 kg/m(2)); group II: 35 anovulatory women with PCOS (BMI <25 kg/m(2)); group III: 20 ovulating women (controls) without hyperandrogenemia (BMI <25 kg/m(2)); women of group III were volunteers. INTERVENTION(S): Blood samples were collected between the 3rd and the 6th day of the menstrual cycle of the ovulating women, and between the 3rd and the 6th day of a spontaneous bleeding of the anovulatory women, at 9 a.m., after an overnight fast. MAIN OUTCOME MEASURE(S): Serum levels of FSH, LH, PRL, 17alpha-hydroxyprogesterone, sex hormone-binding globulin, androgens, insulin, resistin, and glucose. RESULT(S): Resistin levels were found to be significantly increased in group I compared with those of group II and those of group III. No significant difference in resistin levels was found between groups II and III, despite significant differences in insulin levels and the glucose-to-insulin ratio. Multiple regression analysis showed that resistin levels do not correlate with any parameter independent of BMI. CONCLUSION(S): Based on the above findings, we presume that resistin is unlikely to be a major determining factor of PCOS-associated insulin resistance and is not actively involved in the pathogenesis of the syndrome.     

PCOS大鼠模型脂肪组织中抵抗素mRNA和蛋白的表达及其意义

目的:研究多囊卵巢综合征(PCOS)大鼠动物模型其脂肪组织中抵抗素mRNA和蛋白的表达与其性激素变化及胰岛素抵抗(IR)的关系。方法:以脱氢表雄酮(DHEA)皮下注射21日龄SD雌性大鼠造模,观察卵巢重量、光镜(HE染色)及透视电镜改变,测定糖耐量、血清胰岛素、E2、T、P、PRL、FSH、LH水平,采用RT-PCR法及Western blot技术检测其脂肪组织中抵抗素mRNA和蛋白的表达。结果:实验组卵巢重量显著高于对照组(P<0.05),实验组卵巢呈多囊样改变而黄体形成比例减少;实验组血清T、E2和空腹血糖、胰岛素水平明显高于对照组(P<0.001、P<0.05、P<0.001、P<0.05),PCOS模型大鼠白色脂肪组织中抵抗素mRNA和蛋白表达均显著高于对照组(P<0.05)。结论:DHEA诱导的PCOS大鼠动物模型与PCOS病人相似,且有IR现象;由白色脂肪组织分泌的抵抗素在PCOS的发生机制中起着一定的作用。     

Serum resistin level is a predictor of ovarian response in in vitro fertilisation cycle

OBJECTIVES: To measure serum resistin levels in infertile women undergoing in vitro fertilisation-embryo transfer (IVF-ET), and to find any correlations between serum resistin levels and body weight, body mass index, the number of oocytes retrieved, and the outcome of IVF-ET. In addition, to assess whether there is any difference in serum resistin levels between infertility caused by polycystic ovary syndrome (PCOS) and infertility caused by other female factors. METHODS: We designed a case-control study, and a total of 44 infertile women were enrolled. The blood samples for resistin measurement were collected on day 3 of the menstrual cycle prior to the administration of gonadotropin during in vitro fertilisation. These cases were then divided into 2 subgroups (PCOS group versus non-PCOS group) and a number of variables were measured and compared, including serum resistin levels. RESULTS: Serum resistin levels were inversely correlated with the number of oocytes retrieved (r=-0.371, p=0.013). No significant correlation was found between serum resistin levels and body mass index or body weight, either in the whole group or in the 2 subgroups. Serum resistin levels in the non-PCOS group were significantly higher than in the PCOS group (p=0.049). Serum resistin levels in the non-PCOS group were inversely correlated to the number of oocytes retrieved (r=-0.386, p=0.039), but no similar correlation was found in the PCOS group. There was no correlation between serum resistin levels and fertility rate or clinical pregnancy rate in either subgroup. CONCLUSIONS: We observed a negative correlation between serum resistin levels and the number of oocytes retrieved during IVF. However, this phenomenon was only present in the non-PCOS group. This result suggests that serum resistin levels might be a good predictor of ovarian response in infertile women without PCOS during IVF. The role of serum resistin in response to inflammation caused by endometriosis or chronic pelvic infection, both of which are major causes of female infertility, should be examined in a further study.     

多囊卵巢综合征患者卵泡液LIF、IL-1β及性激素水平与IVF-ET结局关系的研究

目的:探讨多囊卵巢综合征(PCOS)患者卵泡液中白血病抑制因子(LIF)、白细胞介素-1β(IL-1β)及性激素水平与IVF-ET结局的关系。方法:用酶联免疫双抗夹心法和时间分辨免疫荧光法前瞻性研究了行IVF-ET的11例PCOS患者、14例对照组患者卵泡液中IL-1β、LIF及雌二醇(E2)和孕酮(P)的定量表达。结果:PCOS组卵泡液中LIF为21.1±11.1pg/mL,P为191.9×103nmol/L,明显低于对照组(33.5±11.8pg/mL,305.9×103nmol/L,P<0.05);而PCOS组卵泡液IL-Iβ为39.9±11.5pg/mL,E2浓度为3334.00nmol/L,明显高于对照组(28.3±10.6pg/mL,2138.1nmol/L),P<0.05。PCOS组胚胎种植率为8.8%,临床妊娠率为18.2%,明显低于对照组(16.7%,42.9%),P<0.05;PCOS组OHSS发生率为27.3%,明显高于对照组(7.1%,P<0.05)。LIF与E2在两组患者呈负相关(r=-0.442,P=0.027)、LIF与LH/FSH比值在PCOS组呈负相关(r=-0.682,P=0.021);IL-Iβ与E2在PCOS组呈正相关(r=0.612,P=0.045);LH/FSH比值与P在PCOS组呈负相关(r=-0.780,P=0.005);LIF与IL-Iβ水平两者间无明显相关性。结论:LIF可能是PCOS患者低种植率的关键因子;IL-Iβ可能是PCOS患者在控制性超排卵过程中易发生OHSS的一个致病因子;卵泡液IL-Iβ、LIF受卵巢激素调控。     

PCOS患者卵泡液内IGF-Ⅰ的水平对卵母细胞成熟的影响

目的:探讨PCOS患者卵泡液内胰岛素样生长因子-Ⅰ(IGF-Ⅰ)的水平与卵母细胞发育成熟的关系。方法:选取因PCOS接受IVF治疗的患者41例为PCOS组、同期因输卵管因素接受治疗的患者37例为对照组。在取卵日根据卵泡直径进行分组,分为≤14mm组和>14mm组,每例患者留取不同直径3～4个卵泡的卵泡液。分别检测PCOS组和对照组患者卵泡液内IGF-Ⅰ的水平,并分析其与卵母细胞成熟和受精的关系。结果:PCOS组IGF-Ⅰ、雌二醇(E2)、睾酮(T)的水平显著高于对照组(P<0.05),与卵泡直径不相关。在卵泡直径≤14mm组,PCOS患者卵母细胞成熟率和受精率明显高于对照组(P<0.05)。在卵泡直径>14mm组,PCOS组与对照组间卵母细胞成熟率和受精率无差异性。PCOS组卵泡液内IGF-Ⅰ水平和E2、T呈正相关(P<0.05)。结论:PCOS患者促排卵过程中卵泡液内IGF-Ⅰ水平的升高与卵泡直径无相关性,而卵泡液内高IGF-Ⅰ水平可影响PCOS患者小于14mm卵泡的卵母细胞成熟和受精。     

卵巢黄素化颗粒细胞瘦素信号转导分子STAT3磷酸化在多囊卵巢综合征发病中的作用

目的:探讨瘦素在多囊卵巢综合征(PCOS)发病中的作用。方法:选择行IVF-ET治疗的30例PCOS患者根据体重指数(BMI)分为肥胖者(BMI≥24)15例和非肥胖者(BMI<24)15例,及同期排卵功能正常或单纯输卵管因素不孕的非PCOS肥胖者和非肥胖者各15例,采用ELISA检测各组血清瘦素水平;采用放射免疫法检测各组空腹血清胰岛素(FIN)水平;采用葡萄糖氧化酶法测定各组空腹血糖(FPG)水平,利用稳态模型(HOMA)计算胰岛素抵抗指数(即HOMA-IR);采用Western blotting检测卵巢黄素化颗粒细胞信号转导分子STAT3磷酸化水平;同法检测不同浓度的瘦素(0ng/ml、10ng/ml、100ng/ml、1000ng/ml)体外对正常人卵巢黄素化颗粒细胞STAT3磷酸化(p-STAT3)的影响。结果:①血清瘦素水平PCOS肥胖者最高,其后依次为对照组肥胖者、PCOS非肥胖者和对照组非肥胖者,各组之间两两比较,差异均具有显著性(P<0.05);②PCOS患者血清瘦素水平与BMI和HOMA-IR均呈显著正相关(r=0.707,P<0.01;r=0.761,P<0.01);③STAT3水平肥胖PCOS组最高,其后依次为肥胖对照组、非肥胖PCOS组和正常对照组,各组间两两比较,差异均具有显著性(P<0.05);④正常人卵巢黄素化颗粒细胞经不同浓度瘦素处理48h后,p-STAT3水平呈不同程度增加,至瘦素浓度达到100ng/ml时,p-STAT3水平达到高峰,随后呈下降趋势。结论:瘦素可能通过激活JAK2/STAT3信号传导通路参与PCOS排卵障碍的发生。     

Lipid peroxidation in follicular fluid of women with polycystic ovary syndrome during assisted reproduction cycles

OBJECTIVE: To investigate the ovarian lipid peroxidation pattern in polycystic ovary syndrome (PCOS). STUDY DESIGN: Twenty-six women with PCOS who underwent in vitro fertilization and embryo transfer (IVF-ET) cycles between January 1999 and November 2000 at the hospital IVF unit were included in the study. Seventeen regularly cycling women with male factors (oligospermia or azoospermia) were enrolled as the control group. Malondialdehyde (MDA) levels in preovulatory follicular fluid were measured. RESULTS: There was a significant difference in follicular fluid MDA levels among the control (median, 2.23 nmol/mL; range, 0.98-4.93) and PCOS group (median, 3.53 nmol/mL; range, 1.51-4.81). Follicular fluid MDA and plasma progesterone levels correlated positively in the subjects (r = 0.55, p = 0.041) and PCOS group (r = 0.074, p = 0.0001). Plasma luteinizing hormone/follicle stimulating hormone (LH/FSH) levels correlated positively with follicular fluid MDA levels in the PCOS group (r = 0.72, p = 0.0001). CONCLUSION: The specific ovarian lipid peroxidation profile of PCOS patients is probably related to insufficient progesterone production and higher FSH/LH levels.     

Follicular fluid 25-hydroxyvitamin D levels determine fertility outcome in patients with polycystic ovary syndrome

ObjectiveTo determine the possible relationship between follicular fluid 25-hydroxyvitamin D [25(OH)D] levels and fertility outcome of women who underwent IVF/ICSI with the diagnosis of lean polycystic ovary syndrome.Materials and methodsThirty patients who were diagnosed with PCOS according to the Rotterdam criteria and decided on IVF/ICSI were included in the study. Thirty patients who were scheduled for IVF/ICSI for reasons other than PCOS and matched in terms of age and BMI were taken as the control group (non-PCOS). According to BMI values, patients in both PCOS and non-PCOS groups were lean. Women in both groups were aged 21–35 years with a normal BMI (18.5–24.9 kg/m2) and first IVF/ICSI attempt. Both groups of patients were followed up using the antagonist protocol. Vit D levels were measured in serum and follicular fluid (FF) samples taken on the day of oocyte collection. The correlation between FF vit D levels, the number of total oocytes, MII oocytes and 2 PN zygotes, HOMA-IR, hormonal and demographic parameters, clinical pregnancy rate (CPR), live birth rate (LBR), and miscarriage rate were evaluated.ResultsAt the time of oocyte retrieval women with PCOS had similar serum Vitamin D compared to non-PCOS women (21.8 (12.6–24.8) ng/ml vs 22.3 (11.5–25.1) ng/ml, p < 0.54). In FF, assessed on the day of oocyte retrieval, the concentration of Vitamin D was similar in women with PCOS when compared to non-PCOS women (11.2 (9.2–14.4) ng/ml vs 13.3 (11.1–17.4) ng/ml, p < 0.06). For both groups, Vitamin D levels were lower in FF compared to serum vit D. A positive correlation was found between serum and FF Vitamin D concentrations in the full cohort. A positive and significant correlation was found between FF-vit D levels and the number of total oocyte (r = 0.344, p < 0.04) and MII oocyte (r = 0.404, p < 0.02) in the PCOS group. The number of total oocyte, MII oocyte and 2 PN zygotes of the PCOS group were significantly higher than the non-PCOS group. Positive pregnancy test rate, clinical pregnancy and live birth rates were similar in both groups. The miscarriage rates in the non-PCOS group were significantly higher than in the PCOS group. A positive and significant correlation was also found between FF vit D levels and positive pregnancy test (r = 0.566, p < 0.03) and CPR (r = 0.605, p < 0.02) in PCOS group. There was no correlation between FF-vit D levels and live birth and miscarriage rates in neither the PCOS nor the non-PCOS group.ConclusionsBoth serum and FF 25-hydroxyvitamin D level of women with PCOS at the time of oocyte retrieval are similar to non-PCOS controls. While FF 25-hydroxyvitamin D levels correlate with total and MII oocyte counts, positive pregnancy test and CPR, it does not correlate with miscarriage and live birth rates.     

Serum resistin and adiponectin levels in women with polycystic ovary syndrome

Aim.?This study was performed to compare the serum levels of resistin and adiponectin in women with polycystic ovary syndrome (PCOS) and normal controls.

Materials and methods.?Seventy-six patients (36 obese, 40 non-obese) with PCOS and 42 healthy subjects were included in the study. Serum levels of resistin, adiponectin, follicle-stimulating hormone, luteinising hormone, dehydroepiandrosterone sulfate (DHEA-S), 17-hydroxy progesterone, free testosterone, androstenedione, glucose, insulin and lipid parameters were measured. Insulin resistance and carbohydrate metabolism were evaluated by using the homeostasis model (HOMA) and the area under the insulin curve (AUCI).

Results.?Plasma resistin levels, HOMA-IR and AUCI were significantly higher and adiponectin level was lower in women with PCOS than those in healthy women. Plasma resistin levels were similar among obese and non-obese women with PCOS. No correlation was observed between resistin, body mass index (BMI), HOMA-IR, AUCI, insulin, lipid parameters and serum androgen levels. In obese PCOS patients, adiponectin levels were lower than in the lean PCOS patients. A negative correlation was observed among adiponectin, HOMA-IR, AUCI, BMI, testosterone, DHEAS, total-cholesterol, LDL-cholesterol and lipoprotein (a) levels.

Conclusion.?These results suggest that the serum adiponectin level may be involved in the pathogenesis of PCOS. But resistin levels were independently associated with insulin resistance and BMI in PCOS patients. Nevertheless, wider-scale trials are required to be performed on this subject.