轻度子宫内膜异位症不孕患者腹腔液和血清NO水平与IVF-ET结局

目的:明确腹腔液一氧化氮(NO)与轻度子宫内膜异位症(内异症)不孕发病的关系,以及探讨解决轻度内异不孕问题的有效途径。方法:采用荧光法检测60例轻度内异症不孕患者(内异组)、60例输卵管性不孕患者(管性组)和20例对照组患者的腹腔液容积、血清和腹腔液的NO水平,并比较了内异组和管性组的IVF指标。结果:内异组和管性组行IVF-ET后,两组胚胎植入率、妊娠率和流产率均无统计学差异(P>0.05),但受精率内异组显著低于管性组(P<0.05);内异组腹腔液容积显著高于对照组和管性组;对照组、管性组和内异组腹腔液中NO代谢物水平(ΔF/F,中位数)分别为9.98、13.76和20.72,内异组腹腔液中NO代谢物水平增高,与对照组和管性组比较,差异有统计学意义(P<0.017);对照组、管性组和内异组血清中NO代谢物水平(ΔF/F,中位数)分别为12.25、13.00和13.60,三组比较差异无统计学意义(P>0.05)。结论:腹腔液NO水平变化可能与轻度子宫内膜异位症及轻度子宫内膜异位症不孕的发病有关。IVF-ET是治疗与轻度内异相关不孕的有效手段。

Increased nitric oxide levels in peritoneal fluids of minor-endometriosis patients and its relation to IVF-ET outcomes

Objective:To investigate the role of nitric oxide(NO) in the pathogenesis of early endometriosis-associated infertility.Methods: The volume of peritoneal fluids was recorded and the concentration of NO in peritoneal fluid and serum was measured with a fluorescence method using 4,5-diaminofluorescein(DAF-2) as an indicator,in 60 patients with early endometriosis-associated infertility(endometriosis group),60 patients with tubal infertility(tubal infertility group) and 20 patients without infertility(control group).The IVF-ET outcomes between patients with endometriosis and tubal infertility were compared.Results: The volume of peritoneal fluids from endometriosis group patients increased significantly compared with that in tubal infertility group patients and control groups.The concentration of NO in peritoneal fluid of the control group,the tubal infertility group and the endometriosis group was 9.98,13.76 and 20.72,respectively(P<0.017).Furthermore the concentration of NO in serum of the patients of control group,tubal infertility group and endometriosis group was 12.25,13.00,13.60,respectively;there were no significant differences among these three groups.There were no significant differences in implantation rate,pregnancy rate and abortion rate of IVF-ET between endometriosis group patients and tubal infertility group patients.However,the fertilization rate was significantly lower in endometriosis group patients than that in tubal infertility group patients.Conclusion: Changes of nitric oxide in peritoneal fluids may play an important role in the pathogenesis of early endometriosis-associated infertility and IVF-ET may serve as an alternative method for this type of infertility.