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体外受精/卵胞浆内单精子注射中促性腺激素释放激素激动剂和拮抗剂方案下的E选择素、抵抗素和活性氧水平:一项前瞻性队列研究

E-selectin, resistin and reactive oxygen species levels in GnRH -agonist and -antagonist protocols in IVF/ICSI: a prospective cohort study.

作者信息

Siristatidis Charalampos, Askoxylaki Marily, Varounis Christos, Kassanos Dimitrios, Chrelias Charalampos

机构信息

Assisted Reproduction Unit, 3rd Department of Obstetrics and Gynecology, University of Athens, Rimini 1, Chaidari, Athens, 12642, Greece,

出版信息

J Assist Reprod Genet. 2015 Jun;32(6):959-67. doi: 10.1007/s10815-015-0489-z. Epub 2015 May 1.

Abstract

PURPOSE

To compare E-selectin, resistin and reactive oxygen species (ROS) levels in serum and follicular fluid (FF) of subfertile women undergoing Controlled Ovarian Hyperstimulation (COH) during IVF/ICSI cycles, using GnRH-agonist and -antagonist protocols.

METHODS

In this prospective cohort study, 85 subfertile women undergoing IVF/ICSI were included. Participants underwent the GnRH-agonist and -antagonist protocols; and blood samples were collected at three time points: basic (at start of COH), on the day of hCG and at oocyte retrieval (OR); and from the FF from the first follicle aspirate. Clinical and IVF cycle characteristics, were compared between groups, together with the levels of E-selectin, resistin and ROS in serum and FF, through ELISA. Their prognostic value on pregnancy outcomes was examined.

RESULT(S): Examining molecules levels are increasing in serum, from start of COH until OR, irrespectively of the protocol used; FF levels at OR were similar to those in serum at that day. Resistin FF levels were lower in GnRH agonists, compared with the antagonist protocol. Resistin levels at start of COH were associated with clinical pregnancy rates, and this remained significant following adjustment for age, BMI and IVF protocol used, while values of >13.5 ng/ml were associated with a six times greater odd of a pregnancy.

CONCLUSION

E-selectin, resistin and ROS levels are increasing during COH, reaching their highest values at OR, with comparable values measured in the FF at that time. Resistin values >13.5 ng/ml are linked with a 6-fold increase on the odds of a pregnancy.

摘要

目的

比较在体外受精/卵胞浆内单精子注射(IVF/ICSI)周期中,使用促性腺激素释放激素(GnRH)激动剂方案和拮抗剂方案进行控制性卵巢刺激(COH)的亚生育妇女血清和卵泡液(FF)中E选择素、抵抗素和活性氧(ROS)的水平。

方法

在这项前瞻性队列研究中,纳入了85名接受IVF/ICSI的亚生育妇女。参与者接受GnRH激动剂方案和拮抗剂方案;在三个时间点采集血样:基础值(COH开始时)、人绒毛膜促性腺激素(hCG)日和取卵时(OR);并从首次卵泡抽吸获得的FF中取样。比较两组之间的临床和IVF周期特征,以及通过酶联免疫吸附测定(ELISA)检测血清和FF中E选择素、抵抗素和ROS的水平。检查它们对妊娠结局的预后价值。

结果

无论使用何种方案,从COH开始到OR,血清中检测分子水平都在升高;OR时FF水平与当日血清水平相似。与拮抗剂方案相比,GnRH激动剂组的抵抗素FF水平较低。COH开始时的抵抗素水平与临床妊娠率相关,在调整年龄、体重指数(BMI)和所用IVF方案后,这种相关性仍然显著,而抵抗素值>13.5 ng/ml与妊娠几率高出6倍相关。

结论

在COH期间,E选择素、抵抗素和ROS水平升高,在OR时达到最高值,此时FF中的测量值与之相当。抵抗素值>13.5 ng/ml与妊娠几率增加6倍相关。

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