超排卵周期中卵巢颗粒细胞CYP19A1mRNA的表达与卵巢反应性关系的研究

Study on the relationship between CYP19A1 mRNA expression in ovarian granular cells and ovarian response in controlled ovarian hyperstimulation cycles

目的：探讨卵巢颗粒细胞CYP19A1mRNA表达与体外受精-胚胎移植（IVF-ET）控制性超促排卵（COH）周期中卵巢反应性的关系。方法：选取2014年5-8月该院生殖医学中心进入IVF周期的不孕患者27例为研究对象,根据COH后雌二醇（E2）水平和获卵数分为3组：卵巢低反应组9例,正常反应组9例,高反应组9例。比较3组卵巢颗粒细胞CYP19A1mRNA的相对表达量并分析这些指标与卵巢反应的相关性。结果：3组之间窦卵泡数、获卵数、h CG日E2水平、r FSH总用量及MⅡ卵子数/获卵数差异有统计学意义（P〈0.05）;3组之间卵巢颗粒细胞CYP19A1mRNA相对表达量差异有统计学意义（P〈0.05）,高反应组的CYP19A1mRNA相对表达量高于正常反应组,低反应组的表达量最低;CYP19A1mRNA相对表达量与r FSH总用量呈负相关,差异有统计学意义（P〈0.05）,与获卵数及h CG日E2水平呈正相关,差异有统计学意义（均P〈0.05）。结论：COH时颗粒细胞CYP19A1mRNA的表达与卵巢对外源性FSH出现的不同反应有关,表达量高的CYP19A1能更好地介导FSH发挥其作用,并促进多个卵泡的发育。

Objective：To explore the relationship between CYP19A1 mRNA expression in ovarian granular cells and ovarian response in controlled ovarian hyperstimulation（COH） cycles of in vitro fertilization and embryo transfer（IVF-ET）.Methods：Twenty-seven infertile patients entering into IVF cycles in Center of Reproductive Medicine in the hospital from May to August in 2014 were selected as study objects,then they were divided into poor ovarian response group,normal ovarian response group,and high ovarian response group according to estradiol levels and the number of retrieved oocytes after COH,9 patients in each group.The relative expression levels of CYP19A1 mRNA in ovarian granular cells of the three groups were compared,the correlation between the indexes and ovarian response was analyzed.Results：There were statistically significant differences in the number of antral follicles,the number of retrieved oocytes,estradiol level on the day of human chorionic gonadotropin（h CG） injection,the total dose of recombinant follicle stimulating hormone（r FSH）,and the ratio of MⅡ oocytes / the number of retrieved oocytes among the three groups（P〈0.05）; there was statistically significant difference in the relative expression level of CYP19A1 mRNA in ovarian granular cells among the three groups（P〈0.05）; the relative expression level of CYP19A1 mRNA in ovarian granular cells in high ovarian response group was higher than that in normal ovarian response group,the relative expression level of CYP19A1 mRNA in ovarian granular cells in poor ovarian response group was the lowest; there was a significant negative correlation between the relative expression level of CYP19A1 mRNA in ovarian granular cells and the total dose of r FSH（P〈0.05）,the relative expression level of CYP19A1 mRNA in ovarian granular cells was significantly positively correlated with estradiol level on the day of h CG injection（P〈0.05）.Conclusion：The relative expression level of CYP19A1 mRNA in ovarian granular cells after COH is correlated with different responses of ovary to exogenous FSH,high level of CYP19A1 can better play its role by mediating FSH and promote development of multiple follicles.