在常规体外受精周期中，卵泡液硫酸脱氢表雄酮是卵母细胞成熟度和妊娠结局的可靠标志物。
Follicular fluid dehydroepiandrosterone sulfate is a credible marker of oocyte maturity and pregnancy outcome in conventional in vitro fertilization cycles.
作者信息
Chimote Natachandra M, Nath Nirmalendu M, Chimote Nishad N, Chimote Bindu N
机构信息
Department of Endocrinology, Vaunshdhara Clinic and Assisted Conception Centre, Nagpur, India; Department of Embryology, Vaunshdhara Clinic and Assisted Conception Centre, Nagpur, India.
Department of Biochemistry, Vaunshdhara Clinic and Assisted Conception Centre, Nagpur, India.
出版信息
J Hum Reprod Sci. 2015 Oct-Dec;8(4):209-13. doi: 10.4103/0974-1208.170397.
AIM
To investigate if the level of dehydroepiandrosterone sulfate (DHEA-s) in follicular fluid (FF) influences the competence of oocytes to fertilize, develop to the blastocyst stage, and produce a viable pregnancy in conventional in vitro fertilization (IVF) cycles.
SETTINGS AND DESIGN
Prospective study of age-matched, nonpolycystic ovary syndrome (PCOS) women undergoing antagonist stimulation protocol involving conventional insemination and day 5 blastocyst transfer.
MATERIALS AND METHODS
FF levels of DHEA-s and E2 were measured by a radio-immuno-assay method using diagnostic kits. Fertilization rate, embryo development to the blastocyst stage and live birth rate were main outcome measures. Cycles were divided into pregnant/nonpregnant groups and also into low/medium/high FF DHEA-s groups. Statistical analysis was done by GraphPad Prism V software.
RESULTS
FF DHEA-s levels were significantly higher in pregnant (n = 111) compared to nonpregnant (n = 381) group (1599 ± 77.45 vs. 1372 ± 40.47 ng/ml; P = 0.01). High (n = 134) FF DHEA-s group had significantly higher percentage of metaphase II (MII) oocytes (91.5 vs. 85.54 vs. 79.44%, P < 0.0001), fertilization rate (78.86 vs. 74.16 vs. 71.26%, P < 0.0001), cleavage rate (83.67 vs. 69.1 vs. 66.17%, P = 0.0002), blastocyst formation rate (37.15 vs. 33.01 vs. 26.95%, P < 0.0001), and live birth rate (29.85 vs. 22.22 vs. 14.78%, P = 0.017) compared to medium (n = 243) and low (n = 115) FF DHEA-s groups, respectively despite comparable number of oocytes retrieved and number of blastocysts transferred. FF DHEA-s levels correlated significantly with the attainment of MII oocytes (Pearson r = 0.41) and fertilization rates (Pearson r = 0.35).
CONCLUSION
FF DHEA-s level influences the oocyte maturation process and is predictive of fertilization, embryo development to the blastocyst stage and live birth rates in non-PCOS women undergoing conventional IVF cycles.
目的
探讨在传统体外受精（IVF）周期中，卵泡液（FF）中硫酸脱氢表雄酮（DHEA-s）水平是否会影响卵母细胞的受精能力、发育至囊胚阶段的能力以及实现活产。
设置与设计
对年龄匹配、非多囊卵巢综合征（PCOS）且接受拮抗剂刺激方案（包括传统授精和第5天囊胚移植）的女性进行前瞻性研究。
材料与方法
使用诊断试剂盒通过放射免疫分析法测定FF中DHEA-s和E2的水平。受精率、胚胎发育至囊胚阶段的情况以及活产率是主要观察指标。将周期分为妊娠/非妊娠组，也分为低/中/高FF DHEA-s组。采用GraphPad Prism V软件进行统计分析。
结果
与未妊娠组（n = 381）相比，妊娠组（n = 111）的FF DHEA-s水平显著更高（1599 ± 77.45 vs. 1372 ± 40.47 ng/ml；P = 0.01）。尽管获取的卵母细胞数量和移植的囊胚数量相当，但高FF DHEA-s组（n = 134）的中期II（MII）卵母细胞百分比（91.5% vs. 85.54% vs. 79.44%，P < 0.0001）、受精率（78.86% vs. 74.16% vs. 71.26%，P < 0.0001）、卵裂率（83.67% vs. 69.1% vs. 66.17%，P = 0.0002）、囊胚形成率（37.15% vs. 33.01% vs. 26.95%，P < 0.0001）和活产率（29.85% vs. 22.22% vs. 14.78%，P = 0.017）分别显著高于中FF DHEA-s组（n = 243）和低FF DHEA-s组（n = 115）。FF DHEA-s水平与MII卵母细胞的获得（Pearson相关系数r = 0.41）和受精率（Pearson相关系数r = 0.35）显著相关。
结论
FF DHEA-s水平会影响卵母细胞成熟过程，并可预测接受传统IVF周期的非PCOS女性的受精情况、胚胎发育至囊胚阶段的情况以及活产率。
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