输卵管性不孕患者卵泡液中活性氧、超氧化物歧化酶水平与胚胎质量关系

Correlation between the levels of reactive oxygen species and superoxide dismutase in follicular fluid of patients with tubal factor infertility and their low quality of eggs

目的:探究卵泡液中活性氧(ROS)、超氧化物歧化酶(SOD)水平与输卵管因素不孕症患者胚胎质量低下的关系。方法:收集2019年4月-2022年1月于本院因输卵管因素导致不孕症行体外受精-胚胎移植(IVF)助孕患者85例临床资料,通过长效方案促排卵治疗,根据胚胎培养结果,以优质胚胎率为35%为临界值,>35%为A组(n=44例),<35%为B组(n=41例)。收集两组卵泡液,检测其ROS、SOD水平;抽取空腹静脉血,检测血清促卵泡激素、黄体生成素、雌激素与睾酮水平;阴道超声下穿刺取卵,计算获卵数,观察卵子成熟率;体外受精12h后观察其受精率,72h后计算优质胚胎率。采用Pearson法分析ROS、SOD水平与激素水平、胚胎质量关系。结果:A组卵泡液ROS水平(0.81±0.25 ng/ml)低于B组(6.97±1.72 ng/ml),SOD水平(1.14±0.28 IU/ml)高于B组(5.34±1.92 IU/ml)(P<0.05);两组促卵泡激素、雌激素水平无差异(P>0.05),A组黄体生成素、睾酮水平低于B组(P<0.05)。两组获卵数无差异(P>0.05),A组卵子成熟率、受精率、优质胚胎率高于B组(P<0.05)。Pearson法相关性分析,与黄体生成素、睾酮ROS水平呈正相关,SOD水平呈负相关;与受精率、优质胚胎率呈ROS水平负相关,SOD水平呈正相关(均P<0.05)。结论:输卵管因素不孕症患者胚胎质量低下的原因可能为氧化应激,卵泡液中ROS、SOD水平与性激素、受精率、优质胚胎率相关。

Objective:To study the correlation between the levels of reactive oxygen species(ROS)and superoxide dis-mutase(SOD)in follicular fluid of patients with tubal factor infertility and their low quality of eggs.Methods:The clinical data of 85 patients with tubal factor infertility who had accepted ovulation induction therapy by long-acting regi-men and in vitro fertilization-Embryo transfer(IVF-ET)from April 2019 to January 2022 were collected.According to the results of embryo culture and the critical value was identified by 35%of high-quality embryos,44 patients with>35%of high-quality embryos was in group A and 41 patients with。<35%of high-quality embryos was in group B.The follicular fluid of the patients in the two groups was collected for detecting the levels of ROS and SOD.Fasting venous.blood of the patients was obtained to detect the levels of their serum ollicle stimulating hormone,luteinizing hormone,estrogen,and testosterone.The eggs of the patients in the two groups were extracted by puncture under transvaginal ultrasound for calculating the number of eggs and for observing the maturation rate of eggs.The fertilization rate of the patients was observed after 12 hours of IVF-ET,and the high-quality embryo rate of the patients was calculated after 72 hours of IVF-ET.Pearson method was used to analyze the correlation between the ROS and SOD levels of the pa-tients and their hormone levels and egg quality.Results:The ROS level in follicular fluid(0.81±0.25 ng/ml)of the patients in group A was significantly lower than that(6.97±1.72 ng/ml)of the patients in group B,and the SOD level in ollicular fluid(1.14±0.28 IU/ml)of the patients in group A was significantly higher than that(5.34±1.92 IU/ml)of the patients in group B(P<0.05).There were no significant differences in the levels of follicle-stimulating hormone and estrogen of the patients between the two groups(P>0.05),while the levels of luteinizing hormone and testoster-one of the patients in group A were significantly lower than those of the patients in group B(P<0.05).There was no significant difference in the number of eggs obtained of the patients between the two groups(P>0.05).The rates of egg maturation,the fertilization,and high-quality embryo of the patients in group A were significantly higher than those of the patients in group B(P<0.05).Pearson correlation analysis method showed that the luteinizing hormone and testosterone levels of the patients were positive correlation with their ROS level,and were negative correlation with their SOD level.The rates of fertilization and high-quality embryo of the patients were negative correlation with their ROS level,while were positively correlated with their SOD level(all P<0.05).Conclusion:Oxidative stress may be the cause of the low-quality egg of the patients with tubal factors infertility,and the levels of ROS and SOD in follicu-lar fluid of the patients are related to their sex hormones levels,the fertilization rate,and the high-quality embryo rate.