多囊卵巢综合征患者卵泡液白细胞介素-1β水平与体外受精-胚胎移植结局关系的研究

Study on relationship between levels of IL-1β in follicular fluid and IVF-ET outcome in PCOS patients

目的探讨体外受精-胚胎移植(IVF-ET)中GnRH拮抗剂治疗多囊卵巢综合征(PCOS)对患者卵泡液中白细胞介素-1β(IL-1β)的影响及与助孕结局的关系。方法选择2011-08～2012-09在该院生殖医疗中心行IVF-ET的PCOS不孕患者76例,随机分为A组(GnRH拮抗剂组)28例(研究组),B组(GnRH激动剂长方案组)48例(对照组),比较分析两组患者的卵泡液中IL-1β水平及其与助孕结局的关系。结果两组卵泡液中IL-1β浓度比较差异无统计学意义(P>0.05);子宫内膜厚度、获卵数、成熟卵率、受精率、卵裂率、优胚率、种植率、临床妊娠率方面,两组比较差异无统计学意义(P>0.05);A组的Gn总用量、Gn用药天数明显比B组少(P<0.01);A组绒毛膜促性腺激素(HCG)日E2水平低于B组(P<0.05);两组的卵巢过度刺激综合征(OHSS)发生率差异无统计学意义(P>0.05);A组的周期取消率明显低于B组(P<0.01)。结论 IVFET中GnRH拮抗剂治疗PCOS不会改变卵泡液中的IL-1β水平,不影响卵泡的发育、卵母细胞的成熟、受精、卵裂能力及胚胎的着床,故GnRH拮抗剂方案是安全有效的。

Objective To investigate the effect of GnRH antagonist in IVF-ET on IL-1β in follicular fluid and the relationship between GnRH antagonist and IVF-ET outcome in polycystic ovarian syndrome（PCOS） patients.Methods Seventy-six cases of PCOS patients undergoing IVF-ET between August 2011 and September 2012 were divided randomly into two groups： Group A（study group） ： 28 patients with PCOS were subjected to a protocol of gonadotropin-releasing hormone antagonist.Group B（control group） ： 48 patients with PCOS were subjected to a long protocol of gonadotropin-releasing hormone agonist.The level of IL-β of the two groups and the relationships between GnRH antagonist and IVF-ET outcome were analyzed.Results The two groups were similar with respect to IL-1β in follicular fluid（P ＆gt; 0.05）;the two groups were similar with respect to endometrium thickness,the number of oocyte,the mature rate of the oocytes,fertilization rates,cleavage rates,the rate of the high-quality embryos,implantation rate,pregnancy rate（P ＆gt; 0.05）.The doses of gonadotropin and the days of administration in Group A was less than those in Group B（P ＆lt; 0.01）.The levels of serum E2 on day of HCG administration,and the cycle cancellation rate in Group A was lower than that in Group B（P ＆lt; 0.05 or 0.01）.The difference of the incidence rate of OHSS was not significant（P ＆gt; 0.05） between the two groups.Conclusion It is demonstrated that GnRH antagonist in PCOS patients undergoing IVF-ET did not alter levels of IL-1β in follicular fluid,the development of follicle and the oocyte competence.These results demonstrated the high-performance and safety of this drug on controlled ovarian stimulation protocol.