卵丘颗粒细胞的端粒长度与体外受精-胚胎移植妊娠结局的关系

Relationship between telomere length in cumulus cells and pregnancy outcome following in vitro fertilization-embryo transfer

目的颗粒细胞凋亡直接影响胚胎的质量,而端粒参与了细胞增殖的调控,因此,本文探究了卵丘颗粒细胞的端粒长度与体外受精-胚胎移植妊娠结局之间的关系,为胚胎和卵母细胞的评估提供思路。方法选择2015年6月—2016年12月间上午入住舟山市妇幼保健院的87例进行体外受精-胚胎移植的患者作为研究对象。所有患者根据年龄,共分为4组:20~25岁(21例);26~30岁(24例);31~35岁(23例);>35岁(19例)。依据卵母细胞成熟度,将患者分为未成熟卵泡颗粒细胞组(45例)和成熟卵泡颗粒细胞组(42例);依据胚胎移植后孕囊的阴道B超检查,分为妊娠组(43例)和非妊娠组(44例)。比较患者的年龄、卵母细胞的成熟度对卵丘颗粒细胞端粒长度,分析不同成熟度的卵母细胞卵泡液内抗苗勒管激素水平以及不同妊娠结局的卵巢颗粒细胞凋亡情况。所有数据的处理分析均使用SPSS 22.0统计软件。结果 20~25岁组、31~35岁组和>35岁组的患者颗粒细胞端粒长度和卵泡成熟度之间有明显差异,随着年龄的增加,患者体内的成熟卵母细胞的颗粒细胞的端粒长度逐渐变短,端粒的长度与年龄呈负相关(P<0.05)。未妊娠患者与已妊娠的患者之间的颗粒细胞端粒长度比较,未妊娠的患者明显更小,差异具有统计学意义(P<0.05)。未成熟卵母细胞的卵泡液内的AMH水平明显高于成熟的卵母细胞,差异具有统计学意义(P=0.007)。比较非临床妊娠组和临床妊娠组的卵巢颗粒细胞凋亡率,差异具有统计学意义(P<0.05)。结论端粒长度随着患者年龄的增大而缩短,未妊娠患者的端粒长度更短,卵丘颗粒细胞的端粒长度与卵母细胞的成熟度和妊娠结局密切相关,具有临床研究价值。

Objective Granulosa cell apoptosis has a direct impact on the quality of embryos,and the telomere was involved in the regulation of cell proliferation. The aim of this paper is to explore the relationship between telomere length in the cumulus cell and pregnancy outcome following in vitro fertilization-embryo transfer( IVF-ET),and provide ideas for the evaluation of embryos and oocytes. Methods A total of 87 patients undergoing IVF-ET in our hospital between June,2015 and December,2016 were enrolled in this study. The patients were divided into four groups according to their ages:20-25 years old( 21 cases); 26-30 years old( 24 cases); 31-35 years old( 23 cases); over 35 years old( 19 cases).According to the maturation of oocyte,the patients were divided into immature granulosa cell group( 45 cases) and mature granulosa cells group( 42 cases). On the basis of vaginal ultrasound examination of pregnant bursa after embryo transplantation,the patients were divided into pregnancy group( 43 cases) and non-pregnancy group( 44 cases). The age of patients,the maturation of oocyte,telomere length in cumulus cells were compared among different groups; the levels of antiMullerian hormone( AMH) in follicular fluid of oocytes with different maturation and the apoptosis of granulosa cells in different pregnancy outcome group were analyzed. All data processing and analysis were performed using SPSS 22. 0 statistical software. Results There were obvious difference in the telomere length in cumulus cells and maturation of oocyte among the 20-25 years group,31-35 years group and over 35 years group; and telomere length in cumulus cells around mature oocytes shortened gradually with age,the telomere length was negatively correlated with the age of patients( P <0. 05). The telomere length of granulosa cells in the non-pregnancy group was shorter than that in the pregnancy group,the difference was statistically significant( P < 0. 05). The levels of AMH in follicular fluid of immature oocytes were significantly higher than that in mature oocytes,and the difference was statistically significant( P = 0. 007). The difference in the apoptotic rate of ovarian granulosa cells was statistically significant between non-clinical pregnancy group and the clinical pregnancy group( P < 0. 05). Conclusion The length of telomere shortens with age of patients,more obviously in non-pregnancy patients. The telomere length of cumulus cells is closely related with oocyte maturation and pregnancy outcome,with an important clinical research value.