超排卵周期人血清及卵泡液中IGF-II测定及其临床意义

The levels of insulin-like growth factor II in human serum and follicular fluid during superovulation stimulation period and the relationships of IGF-II levels with follicular development and reproductive hormones

目的了解超排卵周期人血清及卵泡液中胰岛素样生长因子II(IGF-II)水平,探讨IGF-II在生殖内分泌中的作用。方法采用放射免疫法(RIA)测定45例超排卵周期取卵日人血清及卵泡液中IGF-II、雌二醇(E2)、孕酮(P)、睾酮(T)、卵泡刺激素(FSH)、黄体生成素(LH)水平,分析IGF-II与卵泡发育、生殖激素及为超排卵而使用r-FSH、人绝经期促性腺激素(hMG)的剂量之间的相关性及意义。结果卵泡液IGF-II(0.60±0.69)μgL,低于血清IGF-II(1.09±1.21)μgL(z=1.975,P<0.05);卵泡液中IGF-II与E2、P水平呈正相关(r=0.620、0.509,均P<0.01);与TE2比值呈负相关(r=0.514,P<0.01),与FSH、LH水平及LHFSH比值无相关性(r=0.033、0.044、0.062,均P>0.05);与直径14mm以上的卵泡数及获卵数呈正相关(r=0.393、0.324,均P<0.05)。血清IGF-II与E2、P、T、FSH、LH水平及TE2均无相关性(均P>0.05),与直径14mm以上的卵泡数及获卵数亦无相关性(r=0.099、0.185,均P>0.05)。血清及卵泡液IGF-II水平与超排卵而使用的r-FSH、hMG剂量均无显著相关性(均P>0.05)。结论IGF-II在卵巢内调节卵巢功能中起了重要作用,可能具有促进卵泡发育、形成优势卵泡的作用,并可能促进卵泡E2、P的分泌。

Objective To measure the levels of insulin-like growth factor Ⅱ （IGF-Ⅱ） in serum and follicular fluid （FF） of patients during superovulation stimulation period, and to investigate the relationships of IGF-Ⅱ levels with follicular development and reproductive hormones in order to discuss the significance of IGF-Ⅱ in reproductive endocrine Methods The serum and follicular fluid samples were collected from 45 patients, who received in-vitro fertilization （IVF） and embryo transfer （ET） at the time of transvaginal oocyte retrieval after ovulation induction. The levels of IGF-Ⅱ, estradiol （E2）,progesterone （P）, testosterone （T）, follicle-stimulating hormone （FSH） and luteinizing hormone （LH） in serum and follicular fluid were measured by radi Y （RIA）. The correlations between the IGF-Ⅱ levels and above hormone levels, the amounts of r-FSH,hMG used for superovulation and follicular development were analyzed with SPSS 10.0 software. Results The concentration of IGF-Ⅱ in FF [（ 0.60±0.69 ）μg/L] was lower than that in the serum [（ 1.09±1.21 ）μg/L]（P〈0.01）. It was found that the IGF-Ⅱ level in FF was positively correlated with E2 or P levels （P≤0.001） and the number of follicles （≥14 mm diameter） or retrievable ova （P〈0.05）, but negatively correlated with T/E2 in FF（P=0.001） and no significant correlation with FSH,LH levels and LH/FSH. On the other hand, the IGF-Ⅱ levels in serum showed no significant correlation with these hormone levels and the number of follicles （≥ 14 mm diameter） or retrievable ova （P〉0.05）. The IGF-Ⅱ levels in the serum and FF showed no significant correlation with the amounts of r-FSH and hMG used for superovulation （P〉0.05）. Conclusion IGF-Ⅱ may promote ovarian follicular development and dominant follicle selection probably, and stimulate E2 and P production by follicles. As an important biological regulator in human ovary, IGF-Ⅱ may play roles in intraovary environment. The levels of IGF-Ⅱ in human body could not show significant statistical correlation with gonadotropins.