体外受精周期颗粒细胞卵泡刺激素受体表达与卵巢反应

目的探讨促排卵周期颗粒细胞卵泡刺激素受体(FSHR)表达与卵巢反应性的关系及其对妊娠结局的影响。方法2006年3月至同年12月,实施体外受精-胚胎移植(IVF-ET)助孕者43名,按获卵数量分为低反应组(<5枚)、正常反应组(5~15枚)和高反应组(>15枚)。采用免疫荧光技术检测各组卵巢颗粒细胞FSHR的表达,比较各组FSHR表达强度、胚胎实验室数据和临床结局。结果颗粒细胞FSHR表达量以高反应组最高,正常反应组次之,低反应组最低,三组组间比较均有显著差异(P<0.05);三组间注射人体绒毛膜促性腺激素(HCG)日血雌二醇(E2)水平、获卵数和冻胚数比较,均有显著性差异(P<0.05);而受精率、卵裂率、种植率及妊娠率比较无显著性差异(P>0.05);相关性分析显示,颗粒细胞FSHR的表达与获卵数(r=0.719)及外周血E2水平(r=0.516)呈显著正相关(均P<0.05),与受精率和卵裂率无明显相关性(P>0.05)。结论促排卵时颗粒细胞FSHR表达和卵巢反应性均较高;FSHR表达量与获卵数和血清E2水平呈正相关。研究提示颗粒细胞FSHR水平可能直接影响卵泡发育。

Relationship between expression of follicle-stimulating hormone receptor in granulose cells and ovarian response in in vitro fertilization cycles

Objective To investigate relationship between levels of follicle-sitimulating horomone receptor(FSHR) and ovarian response induced by gonadotropin hormone,and whether the FSHR expression is correlated with in vitro fertilization(IVF) outcome.Methods Granulose cells were collected from 43 women receiving IVF-embryo transplantation(IVF-ET).According to the number of oocyte,the women were divided into three groups: low response(<5),normal response(5-15),and high response(>15).The expression intensity of FSHR was measured by immunohistochemistry technique.The expression intensity of FSHR on the granular cell,the embryological and clinical outcomes were compared and analyzed. Results The expression of FSHR was significantly different in three groups with the highest in high response group(P<0.05).The number of oocyte retrieved and frozen embryos were significantly different in three groups(P<0.05),and the same to HCG and serum E2.But the fertilization,cleavage,implantation and pregnancy rates were similar in three groups(P>0.05).The FSHR level was positively correlated either with the number of oocyte (r=0.719) or with the serum E2 levels(r=0.516,P<0.05) and had no relation with fertilization and cleavage rates(P>0.05). Conclusion Ovarian response to gonadotropin hormone stimulation is correlated with the level of FSHR in the granulose cells.The development of follicles may be influenced by it.