PCOS患者血清及卵泡液抑制素水平与体外受精结局的相关性

目的:通过检测以经控制性超排卵后(COH)体外受精-胚胎移植(IVF-ET)周期中多囊卵巢综合征(P-COS)患者血清与卵泡液抑制素B(INHB)水平,探讨INHB水平在PCOS患者的卵子发育和成熟中的影响,及可能存在的IN-HB水平与妊娠结局的相关性。方法:采用酶联免疫吸附试验(ELISA)检测IVF周期中71例患者采卵日卵泡液及血清中INHB水平,用化学发光法测定采卵日生殖激素水平,分析其与妊娠结局包括促性腺激素(Gn)用量、获卵数、受精率、优质胚胎数、种植率、临床妊娠率等的相关性及意义。结果:PCOS肥胖组及对照肥胖组卵泡液中INHB水平均低于PCOS非肥胖组(P<0.05),PCOS患者中,妊娠者卵泡液中INHB含量高于未妊娠者,但统计学无显著性差异(P>0.05),卵泡液INHB水平与BMI呈显著负相关,INHB与血清FSH、E2、P、T水平无明显相关性(P>0.05);与获卵数、受精数及子宫内膜厚度等未发现相关性。结论:PCOS患者体内较高水平的INHB提示INHB可能参与了PCOS发病机制的某些环节,最终导致PCOS排卵障碍的发生,INHB水平的降低可能会影响卵子的回收,而影响IVF-ET的结局。

The levels of inhibin B in serum and follicular fluid with polycystie ovary syndrome patients during IVF-ET period and the relationships of inhibin B levels with the transfer outcome

Objective:To measure the levels of inhibin B(INHB)in human serum and follicular fluid during controlled ovarian hyperstimulation in in-vitro fertilization and embryo transfer(IVF-ET)period,in order to investigate the relationships of INHB levels with the transfer outcome.Methods:The levels of INHB in human serum and follicular fluid was determined by enzyme-linked-immune-absorbed assay(ELISA)in 71 cases of in IVF-ET.In addition,the serum hormone levels on the day of translational oocyte retrieval were determined by chemiluminescent immunoassay in these patients.The collection between the INHB levels and hormone levels,number of retrieved oocytes,fertilization rate,embryo implantation rate,number of quality embryos and clinical pregnancy rate analyzed.Results:The follicular fluid levels of INHB in obese women either with PCOS or not was lower than the BMI-matched PCOS groups(P<0.05).In PCOS patients,the INHB levels of women who conceived were higher than those in women who did not conceive.The follicular fluid levels of INHB in PCOS and controlled group were negatively correlated with BMI.The correlation between the INHB levels and sex hormone,the number of eggs,fertilized eggs and thickness of endometrial was not found.Conclusion:The higher INHB concentration with PCOS women suggest that INHB demonstrated significant relationships with the PCOS,and it maybe plays a role in mechanism of the anovulation.The lower level of INHB may impact the numbers of retrieved oocytes and the transfer outcome.