白细胞介素6及肿瘤坏死因子-α对体外受精-胚胎移植结局的影响

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的白细胞介素 -6(IL -6)、肿瘤坏死因子 -α(TNF -α)水平与卵泡发育、卵巢内分泌、激素反应类型、年龄、胚胎质量及妊娠之间的关系。方法 :用放射免疫方法检测了 98例患者 (共 10 2周期 )卵泡早期、卵泡中期和取卵日血清中的IL -6、TNF -α水平及取卵日卵泡液中的IL -6、TNF -α水平。结果 :⑴在超促排卵周期中 ,血清中的IL -6水平及IL -6/TNF -α比值随着卵泡的逐渐发育成熟而逐渐升高 ,但血清TNF -α的水平则随着卵泡发育进程而逐渐降低 ,各组间存在极显著性差异 (P均 <0 .0 0 1) ;⑵取卵日卵泡液中的IL -6、TNF -α水平显著高于血清中上述细胞因子的水平 (P <0 .0 0 1) ,⑶随着获卵数的增加 ,卵泡液中IL -6、TNF -α水平显著降低 (P均 <0 .0 0 1) ;而卵泡液IL -6/TNF -α比值则随着获卵数的增加显著升高 (P均<0 .0 5) ;⑷年龄≤ 3 0岁组卵泡液中的IL -6水平小于年龄 >3 1岁组 (P <0 .0 5) ,年龄 3 1～ 3 5岁组与年龄 >3 5岁组之间的卵泡液IL -6水平无显著性差异 (P >0 .0 5) ,不同年龄组间卵泡液TNF -α水平及IL -6/TNF -α比值均无显著性差异 (P >0 .0 5) ;⑸高质量胚胎比≥ 0 .5组的卵泡液IL -6、TNF -α浓度较 <0 .5组显著降低 (P

The Effect of Interleukin-6 and Tumor Necrosis Factor-α on the Outcome of In Vitro Fertilization-Embryo Transfer

Objective To study the relationshi ps between interleukin-6 and tumor necrosis factor-α in serum and follicular flui d and the development of follicle, endocrine of ovary, hormone reaction type, ag e, embryonic quality and successful pregnancy.Methods Radi oimmune assay(RIA) was used to detect interleukin-6(IL-6) and tumor necrosis fac tor alpha(TNF-α) level in serum on the day of early follicular stage, mid folli cular stage , oocyte retrieval and in follicular fluid on the day of oocyte retr ieval in 98 patients(102 cycles) undergoing in vitro fertilization-embryo transf er.Results ①During the process of controlled ovarian hype rstimulation(COH), the IL-6 level and IL-6/TNF-α ratio in serum increased and t he TNF-α level decreased gradually according to follicular development(P<0. 001,P<0.001,P<0.001,respectively) .②The IL-6 and TNF-αlevel in follicu lar fluid are significantly higher than in serum on the day of oocyte retrieval (P<0.001).③The IL-6 and TNF-α level in follicular fluid decreased signific antly in terms of the increase of the number of harvested oocyte(P<0.001);in contrast IL-6/TNF-α ratio in follicular fluid increased significantly in terms of the increase of the number of harvested oocyte(P<0.05).④The IL-6 levels in follicular fluid of patients whose age is no more than 30 are significantly lower than those whose age range from 31 to 35 and whose age is more than 35 ( P<0.05). No significant difference of IL-6 level in follicular fluid was found between the patients whose age is range from 31 to 35 and those whose age is mo re than 35(P>0.05).There is also no significant difference in TNF-α level a nd IL-6/TNF-α ratio of follicular fluid among different age-groups(P>0.05). ⑤The IL-6 and TNF-α concentration in follicular fluid of the patients whose h igh-quality embryonic ratio is no less than 0.5 are significantly lower than tho se whose high-quality embryonic ratio is less than 0.5(P<0.001),but IL-6/TNF -α ratio of the former is significantly higher than the latter(P<0.001).(6) The IL-6 and TNF-αconcentration in follicular fluid are significantly lower whe n the patient was pregnant versus non-pregnant ( P<0.001 and P<0.05,resp ectively).However, the IL-6/TNF-α ratio is significantly higher when the former compared with the latter(P<0.05).Conclusion The IL-6 and TNF-α in serum and follicular fluid may lead to the change of embryonic qua lity by affecting follicular development, then alter the outcome of in vitro fer tilization-embryo transfer subsequently.