体外受精-胚胎移植中多囊卵巢综合征颗粒细胞凋亡与妊娠结局关系的探讨

Investigation of relationships between the granulosa apoptosis of PCOS and the pregnancy rate in IVF-ET

目的探讨体外受精-胚胎移植中多囊卵巢综合征(PCOS)患者颗粒细胞凋亡与妊娠结局的关系。方法选择2004年2月至6月在北京大学第三医院体外受精-胚胎移植患者,其中PCOS组30例、对照组30例,收集其颗粒细胞,采用流式细胞技术,检测颗粒细胞亚二倍体的含量及凋亡相关蛋白PDCD5单克隆抗体免疫荧光密度;免疫组化法检测凋亡相关蛋白PDCD5、Bcl-2、Bax在颗粒细胞中的表达情况;同时将两组相应的临床指标进行比较。结果两组年龄、基础卵泡刺激素(FSH)、FSH的用量、大中卵泡数、受精率、优质胚胎率和妊娠率比较差异无显著性意义(P>0.05)。而PCOS组取卵总数、小卵泡数、HCG日雌二醇水平及颗粒细胞亚二倍体率、PD-CD5荧光密度、免疫组化PDCD5的积分光密度(IOD)值明显增高,免疫组化Bcl-2的IOD值降低,与对照组比较差异有显著性意义(P<0.05)。PCOS组及对照组的妊娠组颗粒细胞亚二倍体数降低、PDCD5荧光密度降低、免疫组化Bcl-2的IOD值增高,PDCD5的IOD值降低,两组中的妊娠组与非妊娠组比较差异有显著性意义(P<0.05)。结论PCOS患者颗粒细胞凋亡明显增加,颗粒细胞凋亡增加妊娠率降低。

Objective To explore the relationship between granulosa apoptosis of polysystic ovary syndrome（PCOS）and the pregnancy rate in IVF-ET.Methods Between the February and June in 2004 at Peking University Third Hospital,we had selected 30 cases of PCOS and normal ovary in IVF-ET to collect data of granulosa cells;test the apoptotic index and PDCD5 monoclonal antibody fluorescence density with the method of flow cytometry;test the expression of pro-and anti-apoptosis proteins（PDCD5、Bcl-2、Bax）in granulosa cells by using immunohistochemistry;make a comparison between two groups.Results There were no significant differences between two cases in terms of age,basal serum FSH concentration,number of ampules of FSH administered,number of retrieved oocytes,embryo transfer and pregnancy rate.But,it was obvious that the difference was existing between the two cases in subG1 and PDCD5 monoclonal antibody fluorescence density,Bcl-2 and PDCD5 proteins expression in granulosa,serum E2 concentrations at hCG day（P〈0.05）.The difference between the PCOS and the comparison group in pregnancy rate was significant in subG1 and PDCD5 monoclonal antibody fluorescence density,Bcl-2 and PDCD5 proteins expression in granulosa（P〈0.05）.Conclusion The increases in the granulosa apoptosis rate of PCOS is significant.When the apoptosis of granulosa increases,the pregnancy rate shows a decreasing trend.