ART中IGF-I、IGFBP-1与卵子质量及妊娠结局的相关研究

Study of IGF-I and IGFBP-1 level with oocyte quality and pregnancy rate during assisted reproductive technology

目的研究IGF-I、IGFBP-1及IGF-I/IGFBP-1比值与ART中卵子质量、胚胎质量及妊娠率的相关性,期望找到ART妊娠结局预测的良好指标。方法选择2007年7月至12月、年龄小于38岁、第一周期ART患者148例(其中IVF100例,ICSI48例)做为研究对象,分别测定HCG日外周血及取卵日卵泡液中IGF-I、IGFBP-1含量;按助孕方式分为二组,并计算妊娠率;按取卵数分为三组:低反应组(0-3枚卵子),正常反应组(5-15枚卵子),高反应组(≥15枚卵子);按妊娠与否分为二组,并计算卵子成熟率、受精率、卵裂率及优胚率。结合IGF-I、IGFBP-1及IGF-I/IGFBP-1比值进行统计分析。结果IVF和ICSI组无差异;不同反应组间IGF-I水平无差异,血清及卵泡液IGFBP-1水平有明显差异,随获卵数目的增加,IGFBP-1水平有升高趋势,且卵泡液IGF-I/IGFBP-1比值差异显著(P<0.01),低反应组高于高反应组;妊娠组和未妊娠组卵泡液IGF-I/IGFBP-1比值有统计学差异(P<0.01),且与优胚率呈正相关。结论卵巢源性IGFBP-1可能通过表达量的改变调节IGF-1的活性,从而间接参与卵子发育的调控;IGFBP-1水平结合IGF-I/IGFBP-1比值可以部分反应卵子质量,从而可能成为预测ART妊娠结局的一个指标。

Objective： To investigate the effect of IGF-Ⅰ, IGFBP - 1 and IGF-Ⅰ/IGFBP - 1 to oocyte quality and pregnancy rate during assisted reproductive technology, and hope to find marker of ART pregnancy outcome. Methods ： The study population consisted of 148 patients treated in our clinic in 2007. 07 - 12. All of them were first cycles and the age of them was below to 38 years. Levels of IGF-Ⅰ and IGFBP - 1 in serum obtained HCG day and in follicular fluid were analyzed by ELISA. Patients were allocated into groups by fertilization way, the number of oocytes retrieved and pregnancy or not. Statistical analysis was done in different groups binding to oocyte maturing rate, fertility rate, cleavage rate and high - quality embryo rate. Results ： We found significant differences in IGFBP - 1 levels in three differential reaction groups. IGFBP - 1 levels in follicular fluid and serum was correlated to the number of oocytes retrieved. The ratio IGF-Ⅰ/IGFBP - 1 in follicular fluid was higher in low responders than in high responders. We also found the ratio IGF-Ⅰ/IGFBP - 1 in follicular fluid had significant differences between pregnancy group and no pregnancy group, which directly correlated to high - quality embryo rate. Conclusion ： IGFBP - 1 form ovaries could adjust IGF-Ⅰ activity by changing expression level, then participated the procedure of oocyte development indirectly. IGFBP - 1 levels binding to the ratio IGF-Ⅰ/IGFBP - 1 could partial response the quality of oocyte, maybe conduced to predict pregnancy outcome of ART.