多囊卵巢綜合征患者卵泡液內(nèi)胰島素樣生長(zhǎng)因子-Ⅰ和甾體激素對(duì)卵母細(xì)胞成熟的影響.pdf

1、多囊卵巢綜合征患者卵泡液內(nèi)胰島素樣生長(zhǎng)因子一I和甾體激素對(duì)卵母細(xì)胞成熟的影響一摘要目的通過(guò)對(duì)比多囊卵巢綜合征患者(polycysticovariansyndrome，PCOS)與對(duì)照組之J日J(rèn)在取卵同卵泡液內(nèi)胰島素樣生長(zhǎng)因子I(insulinlikegrowthfactorI，IGFI)水平、f；體激素水平、卵母細(xì)胞成熟率、受精率和優(yōu)質(zhì)胚胎率的相互關(guān)系，探討PCOS患者行卵胞漿內(nèi)單精子顯微注射(intracytoplasmiesperm

2、injection，ICSI)周期治療時(shí)卵泡液中胰島素樣生長(zhǎng)因子I、甾體激素水平與卵泡直徑、卵母細(xì)胞成熟、受精的關(guān)系。方法選取因PCOS接受ICSI治療的4l例患者為研究對(duì)象，以及同期因輸卵管因素接受治療的37例患者為對(duì)照組。在取卵同根據(jù)卵泡直徑進(jìn)行分組，分為_(kāi)14mm組，每例患者留取各不同直徑組中34個(gè)卵泡的卵泡液。采用電化學(xué)發(fā)光法(ECLIA)檢測(cè)卵泡液中雌二醇(E2)、睪酮(T)的水平，采用酶聯(lián)免疫吸附法(ELISA)檢測(cè)卵泡液中

3、IGFI的水平，并記錄卵母細(xì)胞成熟度、受精情況及其胚胎質(zhì)量。結(jié)果1當(dāng)卵泡直徑14mm時(shí)，兩組之間卵母細(xì)胞成熟率、受精率和優(yōu)質(zhì)胚胎率均無(wú)顯著差異。無(wú)論卵泡直徑14mm時(shí)，PCOS組卵泡液內(nèi)IGFI、E2、T的水平均顯著高于對(duì)照組(P140時(shí)卵母細(xì)胞成熟率(857％)最高(P14mm時(shí)，無(wú)論P(yáng)COS組或?qū)φ战M不同卵母細(xì)胞成熟度、受精情況和胚胎質(zhì)量間卵泡液內(nèi)IGFI水平的差異均無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論與對(duì)照組相比，PCOS患者取卵同卵泡液內(nèi)IGFI

4、、E2、T水平的升高與卵泡直徑無(wú)相關(guān)性。卵泡液內(nèi)適當(dāng)E2、T的比例影響卵母細(xì)胞的成熟。卵泡液內(nèi)高水EffectoffollicularfluidIGFIandsteroidhormoneslevelsonoocytematurationwithpolycysticovariansyndromeAbstractobjectiveToobservethedifferenceoffollicularfluidIGF—I，steroidhorm

5、oneslevels，oocytematurationrate，fertilizationrateandgoodqualityembryatebetweenPCOSgroupandcontrolgroupToinvestigatetherelationshipbetweenfollicularfluidIGFI，steroidhormoneslevelsandfolliclediameteroocytematurationfrompat

6、ientswithpolycysticovariansyndrome(PCOS)duringintracytoplasmicsperminjection(ICSI)cyclesMethodsFollicularfluid(FF)wereobtainedfrom41womenwithPCOSand37womenofcontrastgrouponoocytepickup(OPEl)dayduringICSIc)’clesAllthefoll

7、iclesweregroupedof_14mmaccordingtothediametersize34follicleswereobtainedfromeachdiametergroupEstradiol(E2)andtestosterone(T)concentrationsineachfollicularfluidwereassessedbyelectrochemiluminesenceimmunoassay(ECLIA)，IGFIl

8、evelsweremeasuredbyenzyme1inkedimmunosorbentassay(ELISA)Results1Infollicleswithdiameterof14mm，therewerenodifferenceinoocytematurationratefertilizationrateandgoodqualityembryatebetweenPCOSgroupandcontrolgroupFFIGFI，E2andT

9、concentrationsinPCOSpatientsweresignificantlyhigherthancontrolgroupinbothydiametergroups(P140，incontrolgrouptheratewasthehighest(734％)withFFE以between75and1104Withthediameterof_14mmFFIGFIlevelsinMIIperiodandnormalfertiliz

10、ationwerehigherthanrelativeMIGVperiodsandabnormalfertilization，andinPCOSgroupFFIGFIlevelsinembryoofAperiodwerehigherthanembryoofBCDperiods(尸O05)ConclusionTheincreasedFFIGFI，E2andTlevelsinPCOSwerenotcorrelatedwithfollicle