来曲唑微刺激超排卵对卵泡液中IGF-I和IGFBP-1水平的影响

目的:探讨来曲唑(LE)微刺激超排卵对卵泡液中胰岛素样生长因子I(IGF-I)和胰岛素样生长因子结合蛋白1(IGFBP-1)水平的影响。方法:96例体外受精-胚胎移植(IVF-ET)患者分为两组,LE微刺激组(42例)采用LE微刺激超排卵,GnRH-a方案组(54例)采用GnRH-a方案超排卵做对照,酶联免疫吸附法(ELISA)检测取卵时平均直径16 mm以上卵泡的卵泡液中IGF-I、IGFBP-1水平。结果:⑴LE组超排卵天数、总促性腺激素(Gn)用量、hCG日血清E2水平、获卵数显著低于GnRH-a组,受精率、优质胚胎率、种植率、临床妊娠率两组相比均无显著性差异(P>0.05);⑵LE组卵泡液中IGF-I水平(197.2±35.6)ng/mL显著高于GnRH-a组水平(118.5±23.8)ng/mL(P<0.05),IGFBP-1水平(3 057.7±346.7)pg/mL显著低于GnRH-a组水平(7 093.9±435.3)pg/mL(P<0.05)。结论:LE微刺激超排卵可刺激卵泡液内IGF-I分泌,使卵巢对Gn敏感性增加,用较少的Gn达到同GnRH-a方案相似的超排卵效果。

Effects of Letrozole-Microstimulated Superovulation on the Levels of IGF-I and IGFBP-I in Follicular Fluid

Objective To investigate the effect of letrozole-microstimulated superovulation on the levels of insulin-like growth factor I(IGF-I) and insulin-like growth factor binding protein 1(IGFBP-1) in follicular fluid.Methods Ninety-six patients for in vitro fertilization-embryo transfer(IVF-ET) were randomly divided into two groups,superovulation was induced with LE microstimulationin group(42 cases),GnRH-a was used as control for superovulation with GnRH-a method(54 cases),then follicular fluid for the follicles of the mean diameter over 16 mm were collected to determine the levels of IGF-I,IGFBP-1with ELISA.Results ⑴The duration of superovulation,total dose of Gonadotropin,serum estradiol(E2) level,the number of oocytes retrieved in LE group were significantly lower than that of GnRH-a group,but there was no signifcant difference in fertility rate,the rate of good quality embryo,implantation rate and clinical pregnancy rate between two groups(P>0.05);⑵The follicular fluid level of IGF-I in LE group(197.2±35.6) ng/mL was significantly higher than GnRH-a group(118.5±23.8) ng/mL(P<0.05),while the follicular fluid level of IGFBP-1 in LE group(3 057.7±346.7) pg/mL was significantly lower than GnRH-a group(7 093.9±435.3) pg/mL(P<0.05).Conclusion The microstimulated superovullation with letrozole could induce the secretion of IGF-I in follicular fluid,increase the sensitivity of ovary to Gonadotropin to acheive the similar effect of GnRH-a method with fewer Gn.