卵泡液和卵裂期胚胎培养液可溶性人类白细胞抗原G(sHLA-G)的表达与IVF-ET结局的相关性研究

目的:探讨卵泡液和卵裂起胚胎培养液中可溶性人类白细胞抗原G(sHLA-G)与卵裂期胚胎发育以及IVF-ET后临床妊娠率的关系,为临床优选卵母细胞及移植胚胎提供一种有效的非侵入性检测途径。方法:采用酶联免疫吸附试验(ELISA)检测取卵日卵泡液及第3日移植胚胎培养液中sHLA-G的表达及表达量,将40例患者分为sHLA-G表达阳性组(n=15)和sHLA-G表达阴性组(n=25)进行比较分析。结果:40份患者卵泡液sHLA-G阳性率为37.5%(15/40),87份第3日移植胚胎培养液中sHLA-G阳性率为56.32%(49/87),卵泡液和胚胎培养液sHLA-G阳性组与阴性组的获卵数和受精率均无差异(P>0.05),sHLA-G阳性组的卵裂率、第3日胚胎卵裂球数、优质胚胎率、临床妊娠率均明显高于阴性组(P<0.05),其中胚胎培养液sHLA-G阳性组的临床妊娠率显著高于阴性组(P<0.01)。结论:sHLA-G在部分卵泡液及早期胚胎培养液中均有表达,反映了胚胎良好的发育和种植潜能,预示着较好的IVF-ET结局,是一种优选卵母细胞和移植胚胎的有效的非侵入性途径。

Relationship between the Expression of sHLA-G in Follicular Fluid and Embryo Culture Fluid and the IVF-ET Outcome

Objective: To investigate the relationship between expression of soluble human leukocyte antigen G(sHLA-G) in follicular fluid and embryo culture fluid and development of cleavage stage embryos and clinical pregnancy rate of IVF-ET and further to provide an effective non-invasive detection method in optimization of oocytes and embryos for implantation.Methods: sHLA-G molecules expression in follicular fluid and embryo culture fluid cultured on the third day was detected by ELISA.Then all 40 patients were divided into sHLAG molecule positive expression group and sHLA-G molecule negative expression group.Results: sHLA-G positive rate was 37.5%(15/40) in follicular fluid and 56.32%(49/87) in embryo culture fluid.In follicular fluid and culture medium which cultured the third day of embryo,there was no significant difference in the number of oocytes retrieved and the fertilization rate(P>0.05) between sHLA-G expression of positive and negative groups.The number of cells,the cleavage rate,the good-quality embryo rate,the clinical pregnancy rate were significantly higher in sHLA-G positive group than those in the negative group(P<0.05),in the positive group of embryo culture fluid sHLA-G expression,the clinical pregnancy rate was significantly higher than that of sHLA-G negative group(P<0.01).Conclusion: sHLA-G molecules were expressed in the part of the follicular fluid and early embryo culture medium,reflected the embryonic development and cultivation potential,and indicated the better outcome of IVF-ET.It is an effective non-invasive way for selecting preferred oocytes and embryos.