摘要
目的探究促性腺激素释放激素(GnRH)诱发的卵巢过度刺激对胚胎着床的影响。方法选取2016年3月至2019年1月鄂州市中心医院诊治的98例进行体外受精-胚胎移植方案进行促成怀孕的患者作为研究对象。根据OHSS分级标准分组,轻度组(n=37),症状恶心,呕吐,腹泻;中度组(n=35),超声检查确定有腹水,胸水;重度组(n=26),血黏度增加,低血容量,尿少。通过超促排卵对女性进行促排卵药物辅助处理;体外受精并记录受精卵数量及质量,记录胚胎发育良好情况,比对各组临床妊娠率及流产率;记录各组患者在进行体外受精-胚胎移植方案身体各项相关激素指标;采用RT-qPCR测定人体中炎症因子IL-2、IL-6和TNF-α的mRNA表达量。结果重度组炎症因子IL-2(3.68±0.54)、IL-6(3.79±0.52)和TNF-α(3.48±0.27)mRNA较中度组(2.78±0.25,2.34±0.14,2.59±0.35)高,中度组较轻度组(1.25±0.16,1.05±0.02,1.44±0.23)mRNA表达升高,差异具有统计学意义(P<0.05);AMH和E2水平检测上自我行为评分发现,重度组(5.89±1.35,5867.88±1826.34)与中度组(4.43±1.57,3328.56±1237.44)比较升高,差异具有统计学意义(P<0.05),中度组较轻度组(2.76±1.68,436.25±114.62)表达升高,差异具有统计学意义(P<0.05)。P水平和基础LH水平含量上重度组较中度组降低,中度组较轻度组降低,差异具有统计学意义(P<0.05)。胚胎着床率、临床妊娠率和流产率比较上,重度组较轻度组、中度组升高,差异具有统计学意义(P<0.05)。结论 GnRH在超促排卵的同时会引起OHSS,造成患者卵巢增大恶心腹痛腹积水等不适,同时会降低胚胎着床率及临床妊娠率,增加患者的流产风险。
Objective To study the effect of gonadotropin-releasing hormone(GnRH)-induced ovarian hyperstimulation on embryo implantation. Methods From March 2016 to January 2019, 98 patients who underwent in vitro fertilization-embryo transfer in our hospital were grouped according to the grading criteria for ovarian hyperstimulation syndrome(OHSS), which were mild group(symptoms of nausea, vomiting, diarrhea, n=37), moderate group(ultrasound examination confirmed ascites, pleural effusion, n=35) and severe group(increased blood viscosity, hypovolemia, oliguria, n=26). Ovarian stimulation was used to assist women in ovulation induction;in vitro fertilization was performed and the number and quality of fertilized eggs and the development of the embryo was recorded;the clinical pregnancy rate and abortion rate of each group was compared;the related hormone indicators of patients were recorded and the mRNA expression levels of inflammatory factors 1 L-2, L-6 and TNF-α were detected by RT-qPCR. Results The expression levels of inflammatory factors of 1 L-2, L-6 and TNF-α RNA in the severe group(3.68±0.54, 3.79±0.52, 3.48±0.27) were higher than those in the moderate group(2.78±0.25, 2.34±0.14, 2.59±0.35), which were higher than those in the mild group(1.25±0.16, 1.05±0.02, 1.44±0.23), all with statistically significant differences(P<0.05). The self-behavior scores of AMH and E2 levels were found to be higher in the severe group(5.89± 1.35, 5586.88±1826.34) than those in the moderate group(4.43±1.57, 3238.56±1237.44), which were higher than those in the mild group(2.76± 1.68, 436.25±114.62), all with statistically significant differences(P<0.05). The P level and the basic LH level were the highest in the mild group and lowest in the severe group, with statistically significant differences among the three groups(P<0.05). The embryo implantation rate, clinical pregnancy rate and abortion rate in the severe group was higher than that in the mild group and the moderate group, with statistically significant differences(P<0.05). Conclusions GnRH can cause OHSS at the same time as super-ovulation, causing discomfort such as ovarian enlargement, nausea, abdominal pain, effusion, etc., which will reduce embryo implantation rate and clinical pregnancy rate, and increase abortion risk.
作者
沈兰
陈春华
叶冬云
南方
SHEN Lan;CHEN Chunhua;YE Dongyun;NAN Fang(Department of Obstetrics and Gynecology,Ezhou Central Hospital,Ezhou 436000,Hubei,China)
出处
《中国性科学》
2020年第4期35-39,共5页
Chinese Journal of Human Sexuality
关键词
促性腺激素释放激素
体外受精-胚胎移植
胚胎着床
卵巢过度刺激综合症
临床路径
Gonadotropin-releasing hormone(GnRH)
In vitro fertilization-embryo transfer
Embryo implantation
Ovarian hyperstimulation syndrome(OHSS)
Clinical pathway