Thum M Y, Bhaskaran S, Bansal A S, Shehata H, Ford B, Sumar N, Abdalla H I
Lister Fertility Clinic, Lister Hospital, London, UK.
Hum Reprod. 2005 May;20(5):1272-6. doi: 10.1093/humrep/deh774. Epub 2005 Apr 13.
To evaluate the association between the absolute counts of the peripheral natural killer (NK) cells (including total CD56(+) NK cells, CD56(dim) NK cells and CD56(bright) NK cells), B cells and T cells on the implantation rate and miscarriage rate after IVF treatment.
This was a prospective observation study. A total of 138 patients who underwent IVF treatment from December 2002 to July 2003 were recruited to the study. Blood samples were obtained on the day of vaginal oocyte retrieval prior to the procedure. The absolute counts of lymphocytes, NK cells, B cells and T cells were identified by flow cytometry. These absolute counts and their relationships to IVF treatment outcome and miscarriage rate were analysed.
There were no significant differences with regard the mean values of absolute lymphocyte count, T cell count, B cell count and NK cell count (including total CD56(+) NK, CD56(dim) NK and CD56(bright) NK cells) between the pregnant and non-pregnant groups and also between the ongoing pregnancy and miscarriage groups. The cause of infertility, duration of infertility, basal FSH levels, number of previous failed IVF treatments, number of previous miscarriages and stimulation characteristics were not significantly different between the pregnant and non-pregnant groups. Previous studies have suggested that women with a history of recurrent miscarriage and those with infertility accompanied by recurrent failed IVF treatments are associated with a peripheral blood NK cell percentage >12%, therefore further analysis of peripheral CD56(+) NK cell levels <12% (group A) and >12% (group B) was performed. There was no significant difference in implantation rate (group A: 17.0%; group B: 23.2%), pregnancy rate (group A: 36.6%; group B: 47.7%) or miscarriage rate (group A: 23.3%; group B: 28.6%).
There were no significant differences between simple enumerations of peripheral blood NK cells (including total CD56(+) NK, CD56(dim) NK and CD56(bright) NK cells), B cells and T cells with IVF treatment outcome and pregnancy outcome. Women who had a peripheral NK cell level >12% did not have higher number of previous pregnancy losses. Importantly their pregnancy rate was not reduced and their miscarriages were not increased compared to women who had a peripheral NK cells level <12%.
评估外周血自然杀伤（NK）细胞（包括总CD56(+) NK细胞、CD56(dim) NK细胞和CD56(bright) NK细胞）、B细胞和T细胞的绝对计数与体外受精（IVF）治疗后着床率和流产率之间的关联。
这是一项前瞻性观察研究。共纳入2002年12月至2003年7月接受IVF治疗的138例患者。在阴道取卵当天手术前采集血样。通过流式细胞术鉴定淋巴细胞、NK细胞、B细胞和T细胞的绝对计数。分析这些绝对计数及其与IVF治疗结局和流产率的关系。
妊娠组与未妊娠组之间以及持续妊娠组与流产组之间，淋巴细胞绝对计数、T细胞计数、B细胞计数和NK细胞计数（包括总CD56(+) NK、CD56(dim) NK和CD56(bright) NK细胞）的平均值无显著差异。妊娠组与未妊娠组在不孕原因、不孕持续时间、基础卵泡刺激素（FSH）水平、既往IVF治疗失败次数、既往流产次数和促排卵特征方面无显著差异。既往研究表明，有复发性流产史的女性以及伴有IVF反复治疗失败的不孕女性外周血NK细胞百分比>12%，因此进一步分析外周血CD56(+) NK细胞水平<12%（A组）和>12%（B组）的情况。着床率（A组：17.0%；B组：23.2%）、妊娠率（A组：36.6%；B组：47.7%）或流产率（A组：23.3%；B组：28.6%）均无显著差异。
外周血NK细胞（包括总CD56(+) NK、CD56(dim) NK和CD56(bright) NK细胞）、B细胞和T细胞的简单计数与IVF治疗结局和妊娠结局之间无显著差异。外周NK细胞水平>12%的女性既往妊娠丢失次数并不更多。重要的是，与外周NK细胞水平<12%的女性相比，她们的妊娠率没有降低，流产率也没有增加。
