不孕症患者体外受精-胚胎移植超促排卵周期中血清同型半胱氨酸、自然杀伤细胞与卵巢反应性的关系

Relationship between serum homocysteine,natural killer cell and ovarian reaction in infertile patients with in vitro fertilization embryo transfer during ovarian hyperstimulation cycle

目的分析不孕症患者体外受精-胚胎移植(IVF-ET)超促排卵周期中血清同型半胱氨酸(Hcy)、自然杀伤细胞(NK细胞)与卵巢反应性的相关性。方法选取2018年5月至2021年5月岳池县人民医院诊治的50例接受IVF-ET治疗且获卵数≥20个或获卵数≤3个的超促排卵周期患者作为异常组,选取同期49例接受IVF-ET治疗且获卵数为4~19个的超促排卵周期患者作为正常组。由研究人员设计基线资料调查问卷,查阅患者病历资料,并检测患者绒毛膜促性腺激素(HCG)注射当天的血清Hcy和NK细胞水平,重点分析不孕症患者IVF-ET超促排卵周期中的血清Hcy、NK细胞水平,分析两者与患者卵巢反应性的关系。结果异常组的血清Hcy、NK细胞水平均高于正常组,差异具有统计学意义(P<0.05);两组其他基线资料、实验室指标比较,差异无统计学意义(P>0.05);多元Logistic回归分析结果显示,不孕症患者HCG注射当天的血清Hcy、NK细胞水平高是不孕症患者卵巢反应性异常的风险因子(OR>1,P<0.05);绘制受试者工作特征曲线,结果显示,不孕症患者HCG注射当天的血清Hcy、NK细胞水平评估患者卵巢反应性异常高风险的曲线下面积均>0.70,评估价值较理想,且以联合评估的价值最好。结论不孕症患者IVF-ET超促排卵周期中血清Hcy、NK细胞水平与卵巢反应性存在一定的关系。

Objective To investigate the correlation between serum homocysteine(Hcy),natural killer cells(NK)and ovarian reaction in infertile patients with in vitro fertilization embryo transfer(IVF-ET)during ovarian hyperstimulation cycle.Methods The medical records of 50 patients who received IVF-ET in Yuechi County People′s Hospital and had more than 20 or less than 3 retrieved oocytes from May 2018 to May 2021 were retrospectively analyzed and set as abnormal group,the medical records of 49 patients who received IVF-ET and their number of retrieved oocytes was in the range of 4-19 at the same time were included and set as normal group.The baseline data questionnaire was designed by researchers,the medical records of patients were consulted,the levels of serum Hcy and NK of patients on the day of human chorionic gonadotropin(HCG)injection were detected,the levels of serum Hcy and NK in infertile patients with IVF-ET during ovarian hyperstimulation cycle were mainly analyzed,the relationship between them and ovarian reaction of patients was analyzed.Results The levels of serum Hcy and NK in the abnormal group were higher than those in the normal group(P<0.05).There was no statistical significant difference in other baseline data and laboratory indexes between the two groups(P>0.05).Logistic regression analysis shows that the high level of serum Hcy and the high proportion of NK on the day of HCG injection were risk factors for abnormal ovarian reaction in infertile patients(OR>1,P<0.05).The receiver operating characteristic(ROC)curve was drawn,the results showed that the area under the curve(AUC)of serum Hcy level and NK ratio on the day of HCG injection in infertile patients in evaluating the high risk of abnormal ovarian reaction in patients were both>0.70,the evaluation value was ideal,and the value of joint evaluation was the best.Conclusions There is a certain relationship between serum Hcy,NK and ovarian reaction in infertile patients with IVF-ET during ovarian hyperstimulation cycle.