人卵泡液转化生长因子-α与体外受精-胚胎移植结局的研究

Investigation on transforming growth factor-α in follicular fluid and the outcomes of in vitro fertilization-embryo transfer

目的:探讨体外受精-胚胎移植(IVF-ET)中卵泡液转化生长因子-α(TGF-α)含量与IVF-ET结局的关系。方法:随机选择接受体外受精-胚胎移植技术治疗,采用黄体期长方案进行控制性超排卵临床妊娠病例73例,未妊娠57例,放免法检测取卵日收集的卵泡液中雌二醇(E2)、孕酮(P)和TGF-α水平,分析各项观察指标。结果:两组患者降调节剂量、降调节天数、促性腺激素(Gn)总量、人绒毛膜促性腺激素(HCG)注射日血清P水平差异有统计学意义(P<0.05);卵泡液TGF-α、E2含量差异无统计学意义(P>0.05),但妊娠组呈增高趋势,卵泡液P值妊娠组显著低于未妊娠组(P<0.05);获卵率、MII卵率、受精率和卵裂率妊娠组高于未妊娠组(P<0.05)。结论:卵泡液中TGF-α能够协调卵泡液局部E2/P比值,从而获得高质量卵子,改善治疗结局。

Objective： To explore the relationship between transforming growth factor -α （TGF-α） in follicular fluid and the outcomes of in vitro fertilization- embryo transfer （IVF- ET） . Methods： During long term protocol of IVF- ET cycles, 130 infertile patients undergoing controlled ovarian hyperstimulation were analyzed, then they were divided into group A （ pregnant group） and group B （ non - pregnant group） according to the clinical outcomes. The levels of TGF-α, estradiol and progesterone in follicular fluid were detected by radioimmunoassay and analysed. Results： There was significant difference in the dose and period of down regulation, amount of gonadotropin and the serum progesterone level on the day of HCG administration between two groups （ P 〈 0. 05 ） . There was no difference in the levels of TGF-α and estradiol in follicular fluid between two groups （ P 〉 0. 05 ）, but the level of progesterone in follicular fluid in pregnant group was lower than that in non - pregnant group （ P 〈 0. 05 ）, the rates of oocytes retrieval, MII oocyte, fertilization oocytes and cleavage embryo reversed （ P 〈 0. 05 ） . Conclusion： TGF-α can adjust local estradiol / progesterone ratio in follicular fluid to obtain high quality oocytes and improve pregnant outcomes.