巨噬细胞集落刺激因子对体外受精-胚胎移植助孕周期结局的影响

Effect of macrophage colony-stimulating factor on the outcomes of in vitro fertilization-embryo transfer

目的:探讨在体外受精-胚胎移植(IVF-ET)过程中血清及卵泡液中巨噬细胞集落刺激因子(M-CSF)的水平与卵巢反应性、卵子发育潜能及妊娠结局之间的关系。方法:收集2008年3～5月在河北医科大学第二医院生殖医学科接受超排卵治疗的58例患者取卵日血清和卵泡液,并用酶联免疫法检测M-CSF水平。结果:①取卵日卯泡液中的M-CSF水平显著高于血清中M～CSF的水平(P<0.01);②随着获卯数的增加,血清M-CSF水平显著上升(P<0.01),年龄<35岁组血清中的M-CSF水平明显高于年龄≥35岁组(P<0.05),Gn支数<25支组血清中的M-CSF水平高于Gn支数≥25支组(P<0.05);③卯母细胞成熟度高组和可利用胚胎率高组,卯泡液M-CSF水平显著高于卵母细胞成熟度低组和可利用胚胎率低组(P均<0.05);④妊娠组血清M-CSF水平显著高于未妊娠组(P<0.01),不同妊娠结局血清M-CSF水平间差异有统计学意义(P<0.05)。结论:卵泡液中存在较高水平的M-CSF,血清M-CSF水平与卵巢反应性有一定关系,M-CSF水平可能影响卵子的发育、胚胎质量,参与胚胎的植入,进而影响妊娠结局。

Objective： To explore the relationship between macrophage colony - stimulating factor （ M - CSF） in serum and follicular fluid and the reactivity of ovary, development of oocytes and pregnant results. Methods ： M - CSF levels in follicular fluid and serum of 58 patients undergoing in vitro fertilization - embryo transfer were detected by enzyme - linked immunosorbent assay （ELISA） on the day of oocyte retrieval . Results： The M - CSF level in follicular fluid was significantly higher than that in serum on the day of oocyte retrieval （ P 〈0. 01 ） . The M - CSF level in serum increased significantly with the increase of amount of harvested ooeyte （ P 〈 0.01 ） . The M - CSF level in serum of patients 〈 35 years was significantly higher than that≥ 35 years （ P 〈 0. 05 ） . The M - CSF level in serum of patients whose amount of gonadotropin 〈 25 was significantly higher than that≥25 （ P 〈 0. 05 ） . （3）The M - CSF levels in follicular fluid of the patients with high mature oocyte ratio and high - quality embryonic ratio were significantly higher than those with low mature oocyte ratio and high - quality embryonic ratio （ P 〈 0. 05, respectively） . The M - CSF level in serum in pregnancy group was significantly higher than that in non - pregnancy group （P 〈0. 01） . There was significant difference in M -CSF level between women with different pregnant results （P 〈0. 05） . Conclusion ： High level of M - CSF in follicular fluid is related to reactivity of ovary, which may affect development of oocytes and quality of embryo, participate in implantation of embryo, then affect pregnant outcomes.