IVF-ET周期多囊卵巢综合征患者卵泡液及血清抵抗素水平的研究

目的:探讨体外受精-胚胎移植(IVF-ET)周期中多囊卵巢综合征(PCOS)患者的卵泡液及血清的抵抗素水平、抵抗素与PCOS表现型的相关关系,以及抵抗素对P-COS妇女的卵子发育与成熟及临床妊娠的影响。方法:选择IVF-ET治疗的不孕妇女82例分为3组:第1组为PCOS肥胖组(BMI>24kg/m2)32例,第2组为PCOS非肥胖组(BMI≤24kg/m2)30例,第3组为非PCOS不孕患者作为对照组20例。在超促排卵周期的取卵日留取外周血和卵泡液,离心(2000r/min,5min)后取上清密封保存于-20℃待测。采用ELISA方法检测血清及卵泡液内抵抗素的水平,分析抵抗素水平与PCOS及其表现型的相关关系,同时比较各组间的获卵数、卵裂数、受精率、植入率、临床妊娠率及流产率。结果:PCOS肥胖组血清抵抗素水平明显高于其它两组(P<0·001),3组的卵泡液内抵抗素水平无差异(P>0·05),3组中卵泡液内的抵抗素水平明显低于血清内的抵抗素水平(P<0·001);PCOS患者的临床妊娠结果与抵抗素无关;1、2组的获卵数、卵裂数明显高于对照组(P<0·05);PCOS组的受精率比非PCOS组低(P<0·05),但是1组与2组间无差异(P>0·05)。3组患者年龄、不孕年限、使用促性腺激素支数以及植入率、临床妊娠率、流产率等无明显差异(P>0·05)。结论:PCOS患者血清抵抗素水平高低与BMI呈正相关,而卵泡液中的抵抗素水平与BMI无明显相关性。抵抗素在PCOS患者的IVF-ET治疗周期及治疗结局中可能不起作用。

Follicular and serum resistin levels in women with polycystic ovarian syndrome during IVF-ET cycles

Objective: To investigate the relationship between the resistin level either in serum or follicular fluid and phenotype of PCOS,and IVF-ET outcome.Methods: Eighty-two patients were classified as follows:group 1: 32 women with PCOS and body mass index(BMI) >24kg/m~2;group 2 : 30 women with PCOS and BMI ≤24kg/m~2;group 3 :20 non-PCOS women undergoing IVF with normal BMI.Blood and follicular fluid samples were collected at the day of follicle aspiration.Resistin levels were measured with a commercial ELISA.Results :There was significant difference in serum resistin levels between group 1 and group 2 or 3(P<0.01),but no significant difference in follicular fluid resistin levels among them.Resistin levels in follicular fluid were unexpectedly significantly lower than serum levels (P<0.01) in both the PCOS and control groups.But neither in follicular fluid nor serum resistin level appeared difference between PCOS pregnancy and not.The number of oocytes of group 1 and 2 was more than group 3(P<0.05).The fertilization rate of group 1,2 was lower than that of contral group(P<0.05),but no significant differences between group 1 and group 2(P>0.05).Morever,no significant correlation was found in ampules of Gn,implantation rate,clinical pregnancy rate,or early miscarriage rate in three groups(P>0.05).Conclusion: There is high correlation between serum resistin levels and PCOS with BMI>24kg/m~2,but not in resistin levels in follicular fluid.Resistin is unlikely to be a major determining factor in the growth and maturation of oocytes during IVF-stimulated cycles in PCOS,and there is no influence upon reproductive outcome of IVF-ET.