巨噬细胞集落刺激因子对体外受精-胚胎移植助孕周期结局的影响

目的:探讨在体外受精-胚胎移植(IVF-ET)过程中血清及卵泡液中巨噬细胞集落刺激因子(M-CSF)的水平与卵巢反应性、卵子发育潜能及妊娠结局之间的关系。方法:收集2008年3～5月在河北医科大学第二医院生殖医学科接受超排卵治疗的58例患者取卵日血清和卵泡液,并用酶联免疫法检测M-CSF水平。结果:①取卵日卯泡液中的M-CSF水平显著高于血清中M～CSF的水平(P<0.01);②随着获卯数的增加,血清M-CSF水平显著上升(P<0.01),年龄<35岁组血清中的M-CSF水平明显高于年龄≥35岁组(P<0.05),Gn支数<25支组血清中的M-CSF水平高于Gn支数≥25支组(P<0.05);③卯母细胞成熟度高组和可利用胚胎率高组,卯泡液M-CSF水平显著高于卵母细胞成熟度低组和可利用胚胎率低组(P均<0.05);④妊娠组血清M-CSF水平显著高于未妊娠组(P<0.01),不同妊娠结局血清M-CSF水平间差异有统计学意义(P<0.05)。结论:卵泡液中存在较高水平的M-CSF,血清M-CSF水平与卵巢反应性有一定关系,M-CSF水平可能影响卵子的发育、胚胎质量,参与胚胎的植入,进而影响妊娠结局。

Effect of macrophage colony-stimulating factor on the outcomes of in vitro fertilization-embryo transfer

Objective:To explore the relationship between macrophage colony-stimulating factor(M-CSF) in serum and follicular fluid and the reactivity of ovary,development of oocytes and pregnant results.Methods:M-CSF levels in follicular fluid and serum of 58 patients undergoing in vitro fertilization-embryo transfer were detected by enzyme-linked immunosorbent assay(ELISA) on the day of oocyte retrieval.Results:The M-CSF level in follicular fluid was significantly higher than that in serum on the day of oocyte retrieval(P<0.01).The M-CSF level in serum increased significantly with the increase of amount of harvested oocyte(P<0.01).The M-CSF level in serum of patients<35 years was significantly higher than that≥35 years(P<0.05).The M-CSF level in serum of patients whose amount of gonadotropin<25 was significantly higher than that≥25(P<0.05).③The M-CSF levels in follicular fluid of the patients with high mature oocyte ratio and high-quality embryonic ratio were significantly higher than those with low mature oocyte ratio and high-quality embryonic ratio(P<0.05,respectively).The M-CSF level in serum in pregnancy group was significantly higher than that in non-pregnancy group(P<0.01).There was significant difference in M-CSF level between women with different pregnant results(P<0.05) .Conclusion:High level of M-CSF in follicular fluid is related to reactivity of ovary,which may affect development of oocytes and quality of embryo,participate in implantation of embryo,then affect pregnant outcomes.