1型11β-羟基类固醇脱氢酶（11βHSD）活性的卵巢调节剂以及卵泡内皮质醇与可的松的比率与体外受精的临床结果相关。

Ovarian modulators of type 1 11beta-hydroxysteroid dehydrogenase (11betaHSD) activity and intra-follicular cortisol:cortisone ratios correlate with the clinical outcome of IVF.

作者信息

Thurston L M, Norgate D P, Jonas K C, Gregory L, Wood P J, Cooke B A, Michael A E

机构信息

Department of Biochemistry and Molecular Biology, Royal Free and University College Medical School (Royal Free Campus), University College London, Rowland Hill Street, London NW3 2PF, UK.

出版信息

Hum Reprod. 2003 Aug;18(8):1603-12. doi: 10.1093/humrep/deg322.

DOI:10.1093/humrep/deg322

PMID:12871869

Abstract

BACKGROUND

Follicular fluid (FF) contains compounds that can modulate NADP(+)-dependent oxidation of cortisol by type 1 11beta-hydroxysteroid dehydrogenase (11betaHSD). The objective of this study was to investigate the relationships between levels of the ovarian modulators of type 1 11betaHSD, intra-follicular cortisol:cortisone ratios and the clinical outcome of IVF cycles.

METHODS

A single random sample of FF was aspirated from each of 132 patients undergoing gonadotrophin-stimulated IVF. Components of FF, resolved using C18 column chromatography, were evaluated for effects on NADP(+)-dependent cortisol oxidation in rat kidney homogenates. Intra- follicular steroid concentrations were measured by radioimmunoassays. Clinical pregnancies were confirmed by ultrasonography at 6 weeks post-embryo transfer.

RESULTS

Levels of the hydrophilic ovarian 11betaHSD stimuli were significantly lower (P<0.0001) and levels of the hydrophobic ovarian 11betaHSD inhibitors were significantly higher (P<0.002) in conception versus non-conception cycles. Intra-follicular cortisol:cortisone ratios increased with the degree of inhibition of 11betaHSD by the hydrophobic FF fractions. FF obtained from conception cycles had significantly higher cortisol:cortisone ratios than samples from non-conception cycles (12.9+/-0.3 versus 8.5+/-0.2, respectively; P<0.0001).

CONCLUSIONS

Conception by IVF is associated with elevated intra-follicular cortisol:cortisone ratios, which reflect low levels of ovarian stimuli and/or high levels of ovarian inhibitors of type 1 11betaHSD.

摘要

背景

卵泡液（FF）中含有能够调节1型11β-羟基类固醇脱氢酶（11βHSD）对皮质醇的NADP(+)依赖性氧化作用的化合物。本研究的目的是探讨1型11βHSD的卵巢调节剂水平、卵泡内皮质醇：可的松比值与体外受精（IVF）周期临床结局之间的关系。

方法

从132例接受促性腺激素刺激的IVF患者中，对每例患者的卵泡液进行单次随机采样。使用C18柱色谱法分离卵泡液的成分，并评估其对大鼠肾匀浆中NADP(+)依赖性皮质醇氧化的影响。通过放射免疫分析法测定卵泡内类固醇浓度。胚胎移植后6周通过超声检查确认临床妊娠。

结果

与未受孕周期相比，受孕周期中亲水性卵巢11βHSD刺激物水平显著降低（P<0.0001），疏水性卵巢11βHSD抑制剂水平显著升高（P<0.002）。卵泡内皮质醇：可的松比值随疏水性卵泡液组分对11βHSD抑制程度的增加而升高。从受孕周期获得的卵泡液的皮质醇：可的松比值显著高于未受孕周期的样本（分别为12.9±0.3和8.5±0.2；P<0.0001）。