卵泡液中FSH、LH水平與不孕患者助孕結(jié)局關(guān)系的探究
發(fā)布時(shí)間：2019-04-25 08:32
【摘要】：背景和目的:卵泡液是卵母細(xì)胞賴(lài)以生存的微環(huán)境,卵泡液除含有普通的營(yíng)養(yǎng)成分以外,還有卵泡細(xì)胞分泌的類(lèi)固醇激素及多種生物活性物質(zhì),對(duì)卵泡的發(fā)育、卵母細(xì)胞的成熟有重要影響,為輔助生殖技術(shù)(assisted reproductive technology,ART)中獲得良好的助孕結(jié)局提供前提條件。卵泡刺激素(follicle-stimulating hormone,FSH)、黃體生成素(luteal hormone,LH)是由腺垂體分泌的兩個(gè)具有協(xié)同作用的促性腺激素,具有刺激顆粒細(xì)胞增生、促進(jìn)甾體激素分泌的作用,是促進(jìn)卵泡發(fā)育、成熟的重要成分。目前大部分研究?jī)H觀察基礎(chǔ)外周血FSH、LH水平與卵巢儲(chǔ)備的關(guān)系及利用基礎(chǔ)外周血FSH、LH預(yù)測(cè)促排卵結(jié)局的作用,而卵泡成熟期靶器官中FSH、LH水平及其與輔助生殖助孕結(jié)局的關(guān)系還有待深入研究。本實(shí)驗(yàn)主要研究不孕患者取卵日卵泡液中FSH和LH水平與體外受精/卵胞質(zhì)內(nèi)單精子顯微注射-胚胎移植(in vitro fertilization/intracytoplasmic sperm injection-embryo transfer,IVF/ICSI-ET)結(jié)局的關(guān)系。方法:選擇2016年3~5月在南昌大學(xué)輔助生殖中心接受常規(guī)長(zhǎng)方案IVF/ICSI-ET治療的111例不孕患者作為研究對(duì)象,收集患者取卵日卵泡液,采用酶聯(lián)免疫吸附試驗(yàn)(enzyme linked immunosorbent assay,ELISA)檢測(cè)其中FSH和LH的水平。1.將患者卵泡液中FSH、LH水平與患者基本情況、基礎(chǔ)性激素水平、HCG日血清激素水平、用藥情況及獲卵數(shù)做相關(guān)分析;2.將接受新鮮胚胎移植的患者按是否獲得臨床妊娠分為兩組:妊娠組與未妊娠組。并將患者基本情況、基礎(chǔ)性激素水平、HCG日血清激素水平、用藥情況、患者獲得的實(shí)驗(yàn)室結(jié)局及卵泡液中FSH、LH水平做兩組間比較;3.將所有樣本按卵泡液FSH水平分為FSH㩳3.0IU/L組(A組)、FSH3.0~7.5 IU/L組(B組)、FSH㧐7.5 IU/L組(C組)。分析患者基本情況、獲卵數(shù)、受精率、優(yōu)質(zhì)胚胎率、多PN受精率、移植率、臨床妊娠率在三組間比較是否存在差異。結(jié)果:1.卵泡液中FSH水平與患者每個(gè)有效卵泡Gn用量呈正相關(guān),與HCG日血E2值及獲卵數(shù)呈負(fù)相關(guān)(P㩳0.01);卵泡液中LH水平與患者每個(gè)有效卵泡Gn用量及HCG日血LH值呈正相關(guān),與獲卵數(shù)呈負(fù)相關(guān)(P㩳0.05),但相關(guān)性均較弱。2.妊娠組與未妊娠組之間受精率、優(yōu)質(zhì)胚胎率及卵泡液FSH水平存在顯著差異(P㩳0.01),而其他指標(biāo)兩組間無(wú)統(tǒng)計(jì)學(xué)差異(P㧐0.05)。3.卵泡液FSH水平不同的三組中,B組優(yōu)質(zhì)胚胎率、妊娠率均顯著高于A組、C組(P㩳0.05)。B組受精率也高于C組,差異有統(tǒng)計(jì)學(xué)意義(P㩳0.05)。結(jié)論:卵泡液FSH水平與IVF/ICSI-ET結(jié)局相關(guān),濃度在3.0~7.5 IU/L時(shí)IVF/ICSI-ET結(jié)局最佳。由于本實(shí)驗(yàn)中患者卵泡液LH水平均處于較低水平,尚不能對(duì)卵泡液中LH水平與助孕結(jié)局的關(guān)系作出評(píng)價(jià)。
[Abstract]:Background and objective: follicular fluid is the microenvironment for oocytes to survive. Follicular fluid not only contains common nutritional components, but also contains steroid hormones secreted by follicular cells and various bioactive substances to the development of follicles. The maturation of oocytes plays an important role, which provides a prerequisite for obtaining a good outcome of assisted pregnancy in assisted reproductive technology (assisted reproductive technology,ART). Follicle-stimulating hormone (follicle-stimulating hormone,FSH) and luteinizing hormone (luteal hormone,LH) are two synergetic gonadotropins secreted by adenohypophysis, which can stimulate the proliferation of granulosa cells and promote the secretion of steroids. It is an important component to promote follicular development and maturation. At present, most studies have only observed the relationship between basal peripheral blood FSH,LH level and ovarian reserve and the role of basal peripheral blood FSH,LH in predicting the outcome of ovulation induction, while FSH, in target organs during follicular maturation is only observed. The relationship between LH level and assisted reproductive outcomes remains to be further studied. The purpose of this study was to investigate the relationship between the levels of FSH and LH in follicular fluid of infertile patients and the outcome of in vitro fertilization / intracytoplasmic sperm microinjection-embryo transfer (in vitro fertilization/intracytoplasmic sperm injection-embryo transfer,IVF/ICSI-ET). Methods: from March to May 2016, 111 infertile patients who received routine long-term IVF/ICSI-ET therapy in the Auxiliary Reproductive Center of Nanchang University were selected as subjects. Follicular fluid was collected from the patients, and enzyme-linked immunosorbent assay (enzyme linked immunosorbent assay,) was used to detect the follicular fluid. ELISA) in which the levels of FSH and LH were detected. The level of FSH,LH in follicular fluid of the patients was correlated with the basic condition, basic hormone level, serum hormone level on the day of HCG, drug use and the number of eggs obtained. 2. The patients who received fresh embryo transfer were divided into two groups according to whether they got clinical pregnancy or not: pregnant group and non-pregnant group. The basic condition, basic hormone level, serum hormone level on day of HCG, drug use, laboratory outcome and FSH,LH level in follicular fluid were compared between the two groups. All samples were divided into FSH?3.0IU/L group (group A), FSH3.0~7.5 IU/L group (group B) and FSH?7.5 IU/L group (group C) according to the level of FSH in follicular fluid. The patients' basic condition, number of eggs, fertilization rate, high quality embryo rate, multiple PN fertilization rate, transplantation rate and clinical pregnancy rate were compared among the three groups. Results: 1. The level of FSH in follicular fluid was positively correlated with the dosage of Gn in each effective follicle of the patient, and negatively correlated with the E _ 2 value of blood and the number of eggs obtained on the day of HCG (P0. 01). The level of LH in follicular fluid was positively correlated with the dosage of Gn in each effective follicle and the value of LH in blood on the day of HCG, but negatively correlated with the number of oocytes obtained (P0. 05), but the correlation was weak. There were significant differences in fertilization rate, quality embryo rate and follicular fluid FSH level between pregnant group and non-pregnant group (P0. 01), but there was no significant difference in other indexes between the two groups (P < 0. 05). Among the three groups with different levels of FSH in follicular fluid, the rate of high quality embryo and pregnancy in group B was significantly higher than that in group A, and the fertilization rate in group C (P0. 05). B group) was also higher than that in group C (P < 0. 05). Conclusion: the level of FSH in follicular fluid is correlated with the outcome of IVF/ICSI-ET, and the best outcome of IVF/ICSI-ET is at the concentration of 3.0 IU/L 7.5 IU/L. Because of the low level of LH in follicular fluid, the relationship between the level of LH in follicular fluid and the outcome of assisted pregnancy can not be evaluated.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R714.8
本文編號(hào)：2464942
[Abstract]:Background and objective: follicular fluid is the microenvironment for oocytes to survive. Follicular fluid not only contains common nutritional components, but also contains steroid hormones secreted by follicular cells and various bioactive substances to the development of follicles. The maturation of oocytes plays an important role, which provides a prerequisite for obtaining a good outcome of assisted pregnancy in assisted reproductive technology (assisted reproductive technology,ART). Follicle-stimulating hormone (follicle-stimulating hormone,FSH) and luteinizing hormone (luteal hormone,LH) are two synergetic gonadotropins secreted by adenohypophysis, which can stimulate the proliferation of granulosa cells and promote the secretion of steroids. It is an important component to promote follicular development and maturation. At present, most studies have only observed the relationship between basal peripheral blood FSH,LH level and ovarian reserve and the role of basal peripheral blood FSH,LH in predicting the outcome of ovulation induction, while FSH, in target organs during follicular maturation is only observed. The relationship between LH level and assisted reproductive outcomes remains to be further studied. The purpose of this study was to investigate the relationship between the levels of FSH and LH in follicular fluid of infertile patients and the outcome of in vitro fertilization / intracytoplasmic sperm microinjection-embryo transfer (in vitro fertilization/intracytoplasmic sperm injection-embryo transfer,IVF/ICSI-ET). Methods: from March to May 2016, 111 infertile patients who received routine long-term IVF/ICSI-ET therapy in the Auxiliary Reproductive Center of Nanchang University were selected as subjects. Follicular fluid was collected from the patients, and enzyme-linked immunosorbent assay (enzyme linked immunosorbent assay,) was used to detect the follicular fluid. ELISA) in which the levels of FSH and LH were detected. The level of FSH,LH in follicular fluid of the patients was correlated with the basic condition, basic hormone level, serum hormone level on the day of HCG, drug use and the number of eggs obtained. 2. The patients who received fresh embryo transfer were divided into two groups according to whether they got clinical pregnancy or not: pregnant group and non-pregnant group. The basic condition, basic hormone level, serum hormone level on day of HCG, drug use, laboratory outcome and FSH,LH level in follicular fluid were compared between the two groups. All samples were divided into FSH?3.0IU/L group (group A), FSH3.0~7.5 IU/L group (group B) and FSH?7.5 IU/L group (group C) according to the level of FSH in follicular fluid. The patients' basic condition, number of eggs, fertilization rate, high quality embryo rate, multiple PN fertilization rate, transplantation rate and clinical pregnancy rate were compared among the three groups. Results: 1. The level of FSH in follicular fluid was positively correlated with the dosage of Gn in each effective follicle of the patient, and negatively correlated with the E _ 2 value of blood and the number of eggs obtained on the day of HCG (P0. 01). The level of LH in follicular fluid was positively correlated with the dosage of Gn in each effective follicle and the value of LH in blood on the day of HCG, but negatively correlated with the number of oocytes obtained (P0. 05), but the correlation was weak. There were significant differences in fertilization rate, quality embryo rate and follicular fluid FSH level between pregnant group and non-pregnant group (P0. 01), but there was no significant difference in other indexes between the two groups (P < 0. 05). Among the three groups with different levels of FSH in follicular fluid, the rate of high quality embryo and pregnancy in group B was significantly higher than that in group A, and the fertilization rate in group C (P0. 05). B group) was also higher than that in group C (P < 0. 05). Conclusion: the level of FSH in follicular fluid is correlated with the outcome of IVF/ICSI-ET, and the best outcome of IVF/ICSI-ET is at the concentration of 3.0 IU/L 7.5 IU/L. Because of the low level of LH in follicular fluid, the relationship between the level of LH in follicular fluid and the outcome of assisted pregnancy can not be evaluated.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R714.8
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，本文編號(hào)：2464942
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