卵泡液中Inhibin B与IVF-ET的相关性

目的探讨卵泡液中抑制素B（Inhibin B）与体外受精-胚胎移植（In-vitro fertilization and embryo transfer,IVF-ET）结局的关系及规律。评价其在IVF-ET过程中对卵子受精、胚胎发育、妊娠结局的作用及临床应用价值。方法对38例输卵管和男性因素不孕症患者进行IVF-ET,检测卵泡液中Inhibin B的含量;分析卵泡液中Inhibin B的含量与获卵数、优质胚胎形成率、妊娠结局的关系。结果卵泡液中Inhibin B的值与获卵数（r=0.455,P〈0.05）、E2（r=0.529,P〈0.05）、胚胎质量（r=0.405,P〈0.05）呈正相关;与年龄（r=-0.445,P〈0.05）呈负相关;在妊娠组卵泡液中含量明显高于非妊娠组（P〈0.05）结论卵泡液中Inhibin B含量可以作为预测妊娠结局的指标。     

多囊卵巢综合征患者GH、IGF-1水平检测对预测体外受精-胚胎移植结局的价值

目的探究多囊卵巢综合征(PCOS)患者生长激素(GH)、胰岛素样生长因子-1(IGF-1)表达水平及其与体外受精-胚胎移植(IVF-ET)结局的关系。方法选取2016年8月至2018年8月本院行IVF-ET的不孕患者92例。其中49例PCOS患者为PCOS组;43例输卵管因素不孕患者为对照组。观察两组卵泡液GH、IGF-1水平及IVF-ET结局;分析卵泡液GH、IGF-1不同水平PCOS患者IVF-ET结局及妊娠与未妊娠患者卵泡液GH、IGF-1水平。结果 PCOS组卵泡液GH、IGF-1水平、获卵数、卵裂数、优质胚胎数、OHSS率均高于对照组,差异有统计学意义(P0.05)。高GH水平PCOS患者获卵数、卵裂数、优质胚胎数、临床妊娠率高于低GH水平者,高IGF-1水平PCOS患者获卵数、卵裂数、优质胚胎数、临床妊娠率高于低IGF-1水平者,差异有统计学意义(P0.05)。PCOS妊娠患者卵泡液GH、IGF-1水平均高于未妊娠者,差异有统计学意义(P0.05)。结论 PCOS患者卵泡液GH、IGF-1水平表达监测对IVF-ET结局具有重要预测价值。     

卵泡液中抗核抗体的表达及其对IVF-ET结局的影响研究

目的研究抗核抗体在IVF-ET患者卵泡液中的表达,探讨卵泡液中抗核抗体表达对IVF-ET结局的影响。方法首次行体外受精-胚胎移植治疗患者,血清检测ANA阳性134例;取卵日收集卵泡液,间接免疫荧光法检测卵泡液中ANA,根据卵泡液ANA检测结果分组比较IVF-ET结局。结果卵泡液检测ANA阳性93例,阴性41例,阳性率69.40%。卵泡液ANA阴性组与阳性组人群的年龄、不孕年限、体重指数、基础内分泌、窦卵泡数、Gn用量、获卵数、MII率、2PN率、可利用胚胎数比较差异无统计学意义,P0.05。阴性组的HCG日E2、优质胚胎数高于阳性组;阴性组的临床妊娠率高于阳性组(36.58%/20.43%),差异有统计学意义,P0.05。结论抗核抗体可在卵泡液检出,卵泡液中ANA的阳性表达可能影响IVF-ET的妊娠结局。     

电针干预对肾虚型PCOS患者影响机制的研究

目的探讨电针干预对肾虚型多囊卵巢综合征(PCOS)患者体外受精-胚胎移植(IVF-ET)中卵细胞质量及妊娠结局的影响,并探讨其作用机理。方法将接受IVF-ET的肾虚型PCOS患者66例随机分为观察组34例,对照组32例,观察组加用电针干预。观察两组患者血清及卵泡液中干细胞因子(SCF)含量以及周期结局的不同。结果1、观察组治疗后肾虚症状改善明显(P(0.05),受精率、卵裂率、优质胚胎率均高于对照组,差异有显著性(P(0.05)。2、观察组取卵日血清、卵泡液SCF水平明显高于对照组(P(0.05)。妊娠组血清、卵泡液SCF水平高于非妊娠组,差异有显著性(P(0.05)。3、观察组临床妊娠率高于对照组,但差异无统计学意义(P0.05)。4、两组患者年龄、不孕年限、体重指数、基础内分泌、治疗前肾虚症状积分、hCG日子宫内膜厚度、血LH、E2、P水平、获卵数、OHSS发生率、周期取消率均无显著性差异(P0.05)。结论对PCOS患者IVF-ET中进行电针干预,可从整体上调节机体内分泌和卵巢局部微环境,提高了卵子质量和临床妊娠率,取得较高的临床效果。     

颗粒细胞上促卵泡素受体与体外受精-胚胎移植的相关研究

目的探讨颗粒细胞上促卵泡素(FSH-R)的含量与体外受精胚胎移植(IVF-ET)结果的关系.方法在38个IVF周期中,将受精后获得的颗粒细胞,采用流式细胞测定仪测定其表面FSH-R的含量,并与IVF结果进行比较.结果颗粒细胞上FSH-R的含量与获卵个数无显著的相关关系(P>0.05).受精率、卵裂率随颗粒细胞上FSH-R的含量增加而增加(r=0.57 P<0.01,r=0.61 P<0.01).妊娠组与非妊娠组的颗粒细胞上FSH-R含量有显著性差异(P<0.0001).结论卵泡液中FSH与颗粒细胞膜上FSH-R相互作用共同促进卵母细胞的成熟和发育.     

不同超排方案对EMT患者卵泡液中VEGF水平及其助孕结局的影响

目的探讨不同超排方案对EMT患者取卵日中卵泡液的VEGF水平及其对助孕结局的影响。方法对腹腔镜下诊断为子宫内膜异位症(II期或以上)并需要进行IVF-ET助孕的90例患者,随机分为A,B,C 3组,分别采用超长方案(A组),孕三烯酮+常规长方案(B组)及常规长方案(C组),及对照组(D组):同期因输卵管因因素采用常规长方案进行IVF-ET助孕的30例患者。比较四组间年龄,不孕年限,基础FSH水平,基础LH水平,基础E2水平,Gn天数,Gn用量,HCG日LH水平,HCG日P水平,HCG日E2水平,取卵日成熟卵泡的卵泡液中VEGF水平,并比较四组间的获卵数,受精率,卵裂率,优胚率,胚胎着床率,临床妊娠率,流产率。结果 EMT常规长方案(C组)与对照组(D组)比较:C组卵泡液中VEGF水平高于D组,优胚率,胚胎着床率及临床妊娠率低于D组,流产率高于D组,差异有统计学意义P0.05);超长方案(A组),孕三烯酮+常规长方案(B组)及常规长方案(C组)3组两两比较卵泡液中VEGF水平比较差异无统计学意义,但A,B两组测量值均低于C组;A,B组优胚率高于C组,A组的胚胎着床率高于B,C组,流产率低于B,C组,比较差异有统计学意义P0.05)。A组的Gn天数,Gn用量明显大于B,C两组,比较差异有统计学意义P0.05);3组妊娠率两比较,A组B组C组,但差异无统计学意义。结论常规长方案进行IVF-ET助孕的EMT患者(C组)卵泡液中VEGF水平高于其因输卵管因素采用常规长方案进行IVF-ET助孕的患者(D组),优胚率及胚胎着床率及临床妊娠率低,流产率高;而超长方案(A组)及孕三烯酮+常规长方案(B组)可降低EMT患者卵泡液中VEGF水平,可获得较高的优胚率,胚胎着床率,有助于改善EMT患者的助孕结局。     

子宫内膜异位症不孕患者体外受精-胚胎移植后受精、妊娠与卵泡输出率的关系研究

目的:研究子宫内膜异位症不孕患者体外受精-胚胎移植(In vitro fertilization embryo transfer,IVF-ET)后受精、妊娠与卵泡输出率(Follicle output rate,FORT)的关系.方法:选取2019年3月至2022年1月本院收治的306例接受IVF-ET治疗的子宫内膜异位症不孕患者作为研究对象,依据FORT界值是否小于等于65分为对照组(n=96)和观察组(n=210)对比两组IVF-ET结局、受精、妊娠情况,分析IVF-ET后受精、妊娠与FORT的相关性.结果:两组人促性腺激素(Gonadotropin,Gn)用量、移植胚胎数无差异(P>0.05),观察组注射雌二醇(Estradiol,E2)水平、获卵数高于对照组(P<0.05).两组卵裂率、种植率无统计学差异(P>0.05),观察组受精率、优质胚胎率、移植周期临床妊娠率均高于对照组(P<0.05).据Pearson相关分析得知,FORT与Gn用量无相关性,而注射E2水平、获卵数、受精率、移植周期临床妊娠率与FORT呈正相关(r=0.889、0.246、0.631、0.371,P<0.05).结论:FORT值对预测卵巢反应性和IVF-ET具有重要价值,水平越高则提示子宫内膜异位症不孕患者IVF-ET结局相对越好.     

疏肝化瘀方对体外受精-胚胎移植周期妊娠结局及GDF-9的影响

目的探讨疏肝化瘀中药对提高IVF-ET超排卵周期所获卵和胚胎质量的作用及其机制。方法将70例因输卵管因素行体外受精-胚胎移植(IVF-ET)的患者随机分为中药+控制性超排卵组(实验组,n=35)和单纯性控制性超排卵组(对照组,n=35),应用Western blotting法检测成熟卵泡液中颗粒细胞GDF-9的表达;并比较组间HCG日血清LH、E2、P水平和获卵数、受精率、优质胚胎率及妊娠率等。结果实验组颗粒细胞中GDF-9的表达显著高于对照组(P0.05);实验组的临床妊娠率(62.54%)显著高于对照组(45.21%)(P0.05)。结论疏肝化瘀中药可以提高颗粒细胞中GDF-9水平,改善卵母细胞质量,提高IVF-ET妊娠率。     

重组人促黄体生成素对排卵障碍性不孕患者IVF治疗结局的影响

目的观察重组人促黄体生成素(r-hLH)对排卵障碍性不孕患者体外受精-胚胎移植(IVF-ET)治疗结局的影响。方法对2017年1月至2018年1月郑州大学第二附属医院142例行IVF-ET治疗的排卵障碍性不孕患者临床资料进行回顾性分析,根据其垂体降调节后月经第3d血清黄体生成素(LH)水平及补充r-hLH情况将患者分为A组(r-hLH组,LH水平1IU/L且行补充r-hLH治疗,n=48)、B组(非r-hLH组,LH水平1IU/L且未予以r-hLH治疗,n=42)及C组(对照组,LH水平1IU/L且未予以r-hLH治疗,n=52)。于人绒毛膜促性腺激素(HCG)日检测3组患者血清LH、雌二醇(E2)水平;比较3组患者促性腺激素(Gn)用量、平均获卵数和平均移植胚胎数差异;于HCG日采集患者血清,于取卵日采集患者卵泡液,检测血清、卵泡液骨形态发生蛋白-15(BMP-15)水平;观察IVF-ET治疗结局。结果 A组血清LH、E2水平均高于B组,血清LH水平低于C组(P0.05);A、C组血清E2水平无显著性差异(P0.05)。3组Gn用量、平均获卵数和平均移植胚胎数无显著性差异(P0.05)。A组HCG日血清BMP-15及取卵日卵泡液BMP-15水平均高于B组,低于C组(P0.05)。A、C组2PN率均高于B组(P0.05),A、C组组间无显著性差异(P0.05)。A、B组优质胚胎率均低于C组(P0.05),A、B组组间无显著性差异(P0.05)。3组着床率、临床妊娠率无显著性差异(P0.05)。结论 r-hLH可有效提升长方案垂体降调节后LH过度抑制排卵障碍不孕患者HCG日的血清E2水平和卵母细胞质量,改善IVF-ET治疗结局。     

多囊卵巢综合征患者血清miR-155、 IL-6水平与IVF-ET妊娠结局的关系

目的 探究多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者血清miR-155、白细胞介素6(interleukin-6,IL-6)水平与体外受精-胚胎移植(IVF-ET)助孕结局的相关性.方法 选取2017年5月至2021年1月在我院接受IVF-ET治疗的150例PCOS不孕患者作为研究对象.根据临床妊娠结局分为妊娠组(n=68)及未妊娠组(n=82).收集两组患者一般资料,酶联免疫吸附试验检测IL-6水平,实时荧光定量PCR法检测血清miR-155水平.Spearman法分析血清IL-6、miR-155水平与睾酮(T)水平、成熟卵率、受精率、优质胚胎率的相关性.多因素Logistic分析影响IVF-ET妊娠结局的因素.结果 妊娠组患者血清IL-6、miR-155及T水平低于未妊娠组(均P＜0.001).妊娠组获卵数、成熟卵率、受精率及优质胚胎率均高于未妊娠组,差异具有统计学意义(均P＜0.001).IL-6、miR-155水平与T水平呈正相关,与成熟卵率、受精率、优质胚胎率呈负相关(均P＜0.001),IL-6、miR-155表达水平呈正相关(r=0.502,P＜0.001).IL-6、miR-155、T是影响PCOS患者IVF-ET妊娠结局的独立危险因素,优质胚胎率是保护因素(均P＜0.05).结论 PCOS患者IVF-ET助孕妊娠成功者血清miR-155、IL-6低表达,与IVF-ET结局指标关系密切,是独立的危险因素.     

Concentrations of leptin and C-reactive protein in serum and follicular fluid during assisted reproductive cycles

BACKGROUND: There are only a few studies that have investigated inflammatory processes during ovarian hyperstimulation, with contradictory results especially concerning outcome. The aim of the study was to investigate the inflammatory markers C-reactive protein and leptin in serum and follicular fluid and to correlate these with the outcome. METHODS: One hundred and sixty-two gonadotrophin stimulated cycles were evaluated. Serum concentrations of leptin and C-reactive protein were measured at the initiation of stimulation, on the day of hCG administration or the day before, and on the day of oocyte retrieval. They were also determined in the follicular fluid. RESULTS: Serum leptin and C-reactive protein levels increased significantly during stimulation until the day of oocyte pick up, but following different patterns. After stimulation, they correlated with each other in serum and follicular fluid, but not with estradiol or progesterone concentration, embryo quality, or the pregnancy rate. CONCLUSIONS: Leptin and C-reactive protein levels change significantly during assisted reproductive treatment. In contrast to estradiol they are, however, not a marker of success.     

Predictive value of serum and follicular fluid leptin concentrations during assisted reproductive cycles in normal women and in women with the polycystic ovarian syndrome

Leptin is an adipocyte-derived hormone which plays a central role in the regulation of body weight and energy homeostasis and in signalling to the brain that adequate energy stores are available for reproduction. Although leptin may affect reproduction by regulating the hypothalamic-pituitary-gonadal axis, recent in-vitro observations indicate that leptin may also have direct intra-ovarian actions. Leptin concentrations were measured in women who succeeded in becoming pregnant within three cycles of in-vitro fertilization (IVF) or gamete intra-fallopian transfer (n = 53), in women who failed to become pregnant within three cycles (n = 50), and in women with polycystic ovarian syndrome (PCOS) (n = 22). It was found that lower follicular fluid leptin concentrations were a marker of assisted reproduction treatment success in normal women. Women with PCOS had higher leptin concentrations than women without such a diagnosis, but this was due to their higher body mass index (BMI). After adjustment for age and BMI, women with PCOS who became pregnant tended to have lower mean follicular fluid leptin concentrations than women with PCOS who did not succeed at becoming pregnant. Further studies exploiting the strengths of the IVF model are needed to assess whether the prognostic role for follicular fluid leptin in human reproduction is independent of other factors, and to elucidate the underlying mechanisms.     

Is granulocyte colony-stimulating factor level predictive for human IVF outcome?

BACKGROUND: We investigated granulocyte colony-stimulating factor (G-CSF) in human reproduction. METHODS: From a total sample of 93 patients, we analysed in group 1 (n = 82) the level of G-CSF and estradiol (E(2)) in serum and follicular fluid (FF) on day of follicular puncture (FP). Furthermore, in response to ovarian stimulation, G-CSF levels in serum were compared between low (n = 11), moderate (n = 53) and high (n = 18) response patients. In group 2 (n = 23) serum for G-CSF assessment was collected throughout menstrual cycle until gestation. Group 3 (n = 11) patients with endometriosis were assessed for G-CSF in serum and FF on day of FP without further differentiation. RESULTS: G-CSF in FF was higher than in serum (P < 0.01). G-CSF in serum increased from low through moderate to high response (P < 0.001); pregnancy rates were 0, 24.5 and 33.5% respectively. G-CSF in serum increased throughout stimulation, reached a peak with ovulation induction (P = 0.01) and decreased until embryo transfer (P=0.001). G-CSF level only in pregnant patients (n = 11) increased from embryo transfer to implantation to gestation (P = 0.005). In endometriosis patients G-CSF in serum and FF was lower than in non-endometriosis patients (P < or = 0.03) and corresponded with low response patients. CONCLUSIONS: G-CSF is involved in follicle development and may be a predictor of IVF outcome.     

Association between interleukin concentration in follicular fluid and intracytoplasmic sperm injection (ICSI) outcome

PROBLEM: The aim of this study was to determine the presence and concentration of interleukin IL-6, IL-8, and granulocyte-macrophage-colony-stimulating factor (GM-CSF) in pre-ovulatory ovarian follicular fluid (FF) of patients undergoing controlled ovarian hyperstimulation for intracytoplasmic sperm injection (ICSI) therapy on one hand, and to find out whether these cytotokine concentrations could be used as a predictive parameter for ICSI outcome. DESIGN: The levels of IL-6, IL-8, and GM-CSF were measured from women that underwent ICSI therapy and the results were compared between the patients who became pregnant after IC     

Antioxidant capacity of follicular fluid from patients undergoing in vitro fertilization

This study measured the antioxidant activity of follicular fluid (FF) in infertile patients and assessed its possible correlation between ovarian stimulation and pregnancy outcomes. Samples from 191 infertile patients undergoing in vitro fertilization-embryo transfer (IVF-ET) were determined by α-diphenyl-β-picrylhydrazyl (DPPH) radical scavenging, reducing power, superoxide radical scavenging, β-Carotene bleaching assay, ferrothiocyanate and thiobarbituric acid assays. The comparison between a positive IVF outcome and FF’s antioxidant activity was also studied. The results showed FF had strong antioxidant activity, which equated to common antioxidants Vc and BHT (100 μg/mL). Patients with endometriosis had less efficient antioxidant activity in FF than that of patients with tubal occlusion or polycystic ovary syndrome. In conclusion, this study detected, for the first time, the antioxidant activity of FF from patients undergoing an IVF and the FF exhibited strong antioxidant activity.     

Interleukin-10 in Preovulatory Follicular Fluid of Patients Undergoing In-Vitro Fertilization and Embryo Transfer

PROBLEM: The present study aimed at investigating the presence of Interleukin-10 (IL-10) in preovulatory follicular fluid (FF) and its possible correlation with 17-β-estradiol (E₂) and progesterone (P) levels, and treatment outcome in patients undergoing in-vitro fertilization-embryo transfer (IVF-ET). METHODS: Twenty consecutive patients with tubal factor infertility who underwent oocyte retrieval for IVF-ET were assayed for pooled, preovulatory FF levels of IL-10, E₂, and P. RESULTS: The mean FF levels of IL-10, E₂, and P were 78.7 ± 104.7 pg/ml, 2,787.0 ± 726.1 pg/ml, and 1.5 ± 0.8 ng/ml, respectively. No correlation was found between preovulatory FF concentration of IL-10, E₂, oocyte number, oocyte fertilization rate, embryo quality, and pregnancy rate. The levels of IL-10 were found to be negatively correlated with P concentration, although not significantly (P = 0.057). CONCLUSION: Interleukin-10 exists in the preovulatory FF. Further investigations are needed to determine the role of IL-10 in the folliculogenesis.     

Relationship between antithyroid antibody and pregnancy outcome following in vitro fertilization and embryo transfer

Objective: To investigate the impact of antithyroid antibody on pregnancy outcome following the in vitro fertilization and embryo transfer (IVF-ET).Methods: A total of 90 patients (156 cycles) positive for antithyroid antibody (ATA+ group) and 676 infertile women (1062 cycles) negative for antithyroid antibody (ATA- group) undergoing IVF/ICSI from August 2009 to August 2010 were retrospectively analyzed.Results: There was no significant difference in the days of ovarian stimulation, total gonadotropin dose, serum E2 level of HCG day and number of oocytes retrieved between the two groups. The fertilization rate, implantation rate and pregnancy rate following IVF-ET were significantly lower in women with antithyroid antibody than in control group (64.3% vs 74.6%, 17.8% vs 27.1% and 33.3% vs 46.7%, respectively), but the abortion rate was significantly higher in patients with antithyroid antibody (26.9% vs 11.8%).Conclusion: Patients with antithyroid antibody showed significantly lower fertilization rate, implantation rate and pregnancy rate and higher risk for abortion following IVF-ET when compared with those without antithyroid antibody. Thus, the presence of antithyroid antibody is detrimental for the pregnancy outcome following IVF-ET.     

Ovarian modulators of type 1 11beta-hydroxysteroid dehydrogenase (11betaHSD) activity and intra-follicular cortisol:cortisone ratios correlate with the clinical outcome of IVF

BACKGROUND: Follicular fluid (FF) contains compounds that can modulate NADP(+)-dependent oxidation of cortisol by type 1 11beta-hydroxysteroid dehydrogenase (11betaHSD). The objective of this study was to investigate the relationships between levels of the ovarian modulators of type 1 11betaHSD, intra-follicular cortisol:cortisone ratios and the clinical outcome of IVF cycles. METHODS: A single random sample of FF was aspirated from each of 132 patients undergoing gonadotrophin-stimulated IVF. Components of FF, resolved using C18 column chromatography, were evaluated for effects on NADP(+)-dependent cortisol oxidation in rat kidney homogenates. Intra- follicular steroid concentrations were measured by radioimmunoassays. Clinical pregnancies were confirmed by ultrasonography at 6 weeks post-embryo transfer. RESULTS: Levels of the hydrophilic ovarian 11betaHSD stimuli were significantly lower (P<0.0001) and levels of the hydrophobic ovarian 11betaHSD inhibitors were significantly higher (P<0.002) in conception versus non-conception cycles. Intra-follicular cortisol:cortisone ratios increased with the degree of inhibition of 11betaHSD by the hydrophobic FF fractions. FF obtained from conception cycles had significantly higher cortisol:cortisone ratios than samples from non-conception cycles (12.9+/-0.3 versus 8.5+/-0.2, respectively; P<0.0001). CONCLUSIONS: Conception by IVF is associated with elevated intra-follicular cortisol:cortisone ratios, which reflect low levels of ovarian stimuli and/or high levels of ovarian inhibitors of type 1 11betaHSD.