血管内皮生长因子水平变化与IVF-ET关系的研究

目的 :探讨体外受精 胚胎移植 (IVF ET)治疗周期的不孕症患者在不同阶段血清及卵泡液内血管内皮生长因子 (VEGF)的浓度变化以及它与卵泡生长发育、卵母细胞成熟、受精、卵裂及胚胎质量的关系。方法 :IVF治疗周期妇女 6 0例 ,在应用促性腺激素前、注射绒毛膜促性腺激素日、取卵日分别抽取外周血 ,穿刺取卵时留取卵泡液 ,应用酶联免疫法 (ELISA)检测血清及卵泡液中VEGF的浓度变化 ,并记录相应卵子的成熟度、受精、卵裂情况与胚胎质量。结果 :(1)控制超排卵过程中 ,随着卵泡的生长发育 ,VEGF浓度逐步升高 ,在取卵日达到较高水平 ;(2 )在控制超排卵过程中 ,卵巢反应类型不同 ,其VEGF水平亦不同 ,卵巢高反应组在取卵日血清中VEGF水平差异有显著性 (P <0 .0 5 )。患者卵泡液中VEGF浓度均明显高于外周血浓度 (P <0 .0 0 1) ;(3)成熟卵的卵泡液中VEGF浓度明显高于未成熟卵 ;(4)受精卵卵泡液中VEGF水平高于未受精卵 ,VEGF浓度高的卵母细胞受精后优质胚胎形成率高 (P <0 .0 5 )。结论 :VEGF调节卵母细胞的成熟、受精、卵裂过程 ,并可能影响早期胚胎的质量。

Study on relationship between the change of vascular endothelial growth factor concentration and IVF-ET

Objective:To study the relationship between vascular endothelial growth factor(VEGF) and follicule development,follicule num ber,oocyte maturing rate,fertilizin g rate,cleavaging rate and the outcomes of embryo transfer.Methods: A total of 60 females in vitro ferti lization(IVF) were studied.Serum samples were collected before the day of injecting FSH,on the day of injecting hCG and retriving oocyte ,respectively.Fol licular fluids were obtained on the day of retriving oocyte.The VEGF concentrati on was measured by sandwich enzymelinked immunoadsorbent ass ay(ELISA);and recorded the degree of oocyte maturation,fertilizing rates,cleavag i ng rates of oocyte,the quality of embryo and the outcome of embryo transfer were recorded. Results:(1)During the program of controlled ovrian hypersti mulation,the VEGF concentration gradually increased along with the developing of f ollicles and came to a higher level on the day of oocytes retrival.(2) The VEGF co ncentrations were different in different responders of controlled hyperstimulati on(COH). The VEGF concentrations in serum of hyper-responders were higher than t hat of the others(P<0.05).The VEGF concentraction in follicular fluids was significanty higher than that in perperay (P <0.001).(3) The VEGF concentration was hi gher in matured oocytes.(4) The VEGF concentration was higher in follicular-flui ds of fertilized oo cytes. The good embryos rate was higher in the oocytes with high follicular fluid VEGF concent ration.Conclusion:VEGF may be an important cytokine in induci ng follicule development and oocytes maturation,fertilization. VEGF may effect the quality of early embryo.