晚期糖基化终产物与输卵管因素不孕症患者卵子发育不良的关系

目的探讨晚期糖基化终产物（AGEs）对卵子质量及颗粒细胞功能的影响。方法选择2015年2~6月，因输卵管因素行体外受精助孕的患者，年龄<35岁，获卵数≥8个，以长效长方案促排卵，取卵时收集所有卵泡液和颗粒细胞冻存。共有19例入选，将优质胚胎率>35%的分为A组（n=10），优质胚胎率<35%的分为B组（n=9）。采用酶联免疫吸附试验抗体夹心法检测取卵日卵泡液AGEs和活性氧水平，采用Real-time PCR检测颗粒细胞RAGE mRNA表达，分析两组之间有无差异。结果两组患者一般资料比较差异无统计学意义，两组的平均优胚数（5.2±2.34 vs 1.50±1.08，P=0.001）和优胚率（60.27%±12.48% vs 21.48%±14.02%，P=0.000）差异有统计学意义；两组患者卵泡液活性氧水平（0.82±0.28 ng/mL vs 1.11±0.27 ng/mL，P=0.000）差异有统计学意义，卵泡液AGEs水平（0.33±0.13 μg/mL vs 0.35±0.13 μg/mL, P=0.462）差异无统计学意义，颗粒细胞RAGE水平（1.55±0.62 pg/mL vs 3.75±1.75 pg/mL，P=0.005）差异有统计学意义。结论氧化应激状态可能是输卵管因素的年轻不孕症患者卵子质量低下的原因，但AGES-RAGE可能并不是其作用途径。

Relationship between AGEs and oocytes dysplasia of patients with tubal factor infertility

ObjectiveTo access the effect of advanced glycation end products（AGEs） on oocyte quality and granulosa cell function for patients with tubal factor infertility.MethodsFrom February 2015 to June 2015, 19 IVF patients with tubal factor were enrolled. All patients were <35 years old.They were controlled ovarian hyperstimulation (COH) with long-acting long protocol and retrieved ≥8 oocytes. Their follicular fluid and granulosa cells were collected during ovum pick-up (OPU) and cryopreserved at –80 ℃. The patients were devided into 2 groups: Group A of 10 patients with high quality embryo rate >35% and group B of 9 patients with high quality embryo rate <35%. Follicular fluid AGEs and ROS levels on OPU day were detected by sandwiched ELISA, and the RAGE mRNA expression of granulosa cells were detected by Real-time PCR.ResultsThere were no significant differences of general informations between two groups (P>0.05). There were significant differences in average numbers of high quality embryos (5.2±2.34 vs 1.50±1.08, P=0.001) and the high quality embryo rate (60.27±12.48 vs 21.48±14.02, P=0.000). Follicular fluid ROS levels in 2 groups were significantly different (0.82±0.28 vs 1.11±0.27 ng/mL, P=0.000). The follicular fluid AGES level in 2 groups were not significantly different (0.33±0.13 vs 0.35±0.13 μg/mL, P=0.462).ConclusionThe oxidative status may be the reason of oocytes dysplasia in the young patients with tubal factor infertility. But AGES-RAGE probably was not the mechanism.