子宫内膜异位症患者卵泡液对精子与透明带结合能力的影响

Follicular fluid from patients with endometriosis decreases the binding of human sperm to zona pellucida in hemizona assay.

目的探讨子宫内膜异位症及非子宫内膜异位症患者卵泡液对精子与透明带结合能力的影响。方法卵泡液取自２０例进行体外授精胚胎移殖的不孕症患者，其中１０例为子宫内膜异位症，１０例为单纯炎症性输卵管不通。应用半透明带配对研究、培养液ＥＢＳＳ／ＢＳＡ做为对照，观察子宫内膜异位症及非子宫内膜异位症患者卵泡液对精子与透明带结合能力的影响。结果经子宫内膜异位症患者卵泡液与非子宫内膜异位症患者卵泡液处理后的精子与透明带结合的数目均明显低于经培养液处理后的精子与透明带结合的数目（９１±２１与２３９±３５，Ｐ＜０．００１；１０９±２２与２１１±４２，Ｐ＜０．００５），经子宫内膜异位症患者卵泡液处理的精子结合半透明带指数明显低于经非子宫内膜异位症患者卵泡液处理后的精子结合半透明带指数（３６±４与５４±４，Ｐ＜０．００５）。结论子宫内膜异位症患者卵泡液对精子与透明带结合能力具有较强的抑制作用，子宫内膜异位症患者卵泡液对配子相互作用的影响可能是其不孕的原因之一。

Objective To evaluate the effects of follicular fluid (FF) from women with endometriosis and tubal factor on sperm binding to zona pellucida under hemizona assay(HZA). Methods Follicular fluid was collected at IVF from patients with endometriosis and without endometriosis (tubal factor infertility). The HZA was used to study the effect of FF from patients with endometriosis and tubal factor on sperm binding to zona pellucida using media (EBSS/BSA) as control. Results The mean number of sperm binding to zona in endometriosis specimens and tubal factor infertility was significantly fewer than the number treated by culture medium (91±21 vs 239±35, P <0.001; 109±22vs 211±42, P <0 005). The hemizona index was lower when the incubation was performed with FF from endometriosis patients compared with sperm incubated in FF from tubal factor patients (36±4vs 54±4, P <0 005). Conclusions The inhibiting effect of FF from endometriosis patients is stronger than those without endometriosis. The follicular fluid of patients with endometriosis could contribute to infertility through impairment of gamete interaction.