IVF周期中外周血淋巴细胞LHCGR mRNA的表达对卵巢过度刺激综合征的预测价值

Expression of Luteinizing Hormone/Choriogonadotropin Receptor mRNA in the Lymphocytes May Identify IVF Patients at Risk of Ovarian Hyperstimulation Syndrome

目的:探讨外周血淋巴细胞人绒毛膜促性腺激素受体(LHCGR)mRNA的表达水平对体外受精-胚胎移植(IVF-ET)患者发生卵巢过度刺激综合征(OHSS)的预测价值。方法:单中心的前瞻性病例-对照研究。108例IVF-ET患者在接受控制性超促排卵(COH)过程中呈OHSS高风险的患者42例,其中发生OHSS 19例为A组,未发生OHSS 23例为B组;同期在COH中卵巢反应正常的患者62例为C组,排除COH过程中卵巢低反应者4例。采用聚合酶链反应(PCR)检测人绒毛膜促性腺激素注射日(hCG日)及取卵日(OPU日)外周血淋巴细胞LHCGR mRNA的表达水平。并比较A组、B组、C组的临床特征及临床结局。结果:基础卵泡刺激素(FSH)A组低于C组(P=0.028)。hCG日及OPU日血清雌二醇(E2)A组、B组均高于C组(均P=0.000)。获卵数A组、B组均高于C组(均P=0.000)。A组与B、C组相比,hCG日和OPU日淋巴细胞LHCGR mRNA表达均增高(均P<0.05);而B组和C组比较,差异均无统计学意义(均P>0.05)。结论:外周血淋巴细胞LHCGR mRNA的表达与卵巢反应相关,并在OHSS患者中表达升高,其在预测OHSS发生中的作用值得进一步探讨。

Objective：To investigate whether women with high risks of ovarian hyperstimulation syndrome （OHSS） undergoing controlled ovarian hyperstimulation have the altered levels of the luteinizing hormone/choriogonadotropin receptor （LHCGR） mRNA in the lymphoeytes. Methods：In this single center prospective study, 108 IVF-ET patients were divided into 3 groups according ovarian response. In 42 cases with high OHSS risks,those 19 cases diagnosed OHSS were group A,the others 23 cases were group B. Those 62 cases with normal ovarian response were group C. The levels of LHCGR mRNA in lymphocytes were detected by PCR technology in the days of hCG injection and ovum pick-up （OPU day）. Results：The level of basal serum FSH in group A was lower than that in group C （P=0.028）. The serum concentration of estradiol （E2） in both group A and group B was higher than that in group C on the days of hCG injection and OPU （P=0.000）. The median numbers of oocytes retrieved per patient in group A and group B were more than that in group C （P= 0.000）. Group A had higher expression of LHCGR in lymphocytes mRNA on the hCG day and OPU day than group B and group C （P〈0.05）. The difference of the levels of LHCGR mRNA in lymphocytes between group B and group C was not significant （P〉0.05）. Conclusions：Expression of LHCGR mRNA in lymphocytes was related to ovarian response, which increased in OHSS patients. It could be used as a marker to predict OHSS.