Jamil Zehra, Fatima Syeda Sadia, Arif Sara, Alam Faiza, Rehman Rehana
Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan.
Dow Medical College, Karachi, Pakistan.
Reprod Biomed Online. 2017 Feb;34(2):147-153. doi: 10.1016/j.rbmo.2016.11.004. Epub 2016 Nov 18.
A cross-sectional study was carried out at the Australian Concept Infertility Medical Centre from June 2014 to June 2015 to relate serum kisspeptin levels on human chorionic gonadotrophin (HCG) day with pregnancy outcome after intracytoplasmic sperm injection (ICSI). A total of 176 women aged 20 to 42 years, with regular menstrual cycles, normal thyroid function and prolactin levels selected for ICSI were included in the study. Patients with uterine fibroids, metabolic disorders, short agonist and antagonist protocol were excluded. Long protocol for down-regulation of ovaries was observed and kisspeptin levels were estimated on HCG day. Results were categorized into groups: Group A, non-pregnant with β-HCG <25 mIU/ml; and Group B, clinical pregnancy with β-HCG >25 mIU/ml and cardiac activity on transvaginal scan. Kisspeptin levels were significantly higher in Group B versus Group A (P < 0.001), independently associated with positive pregnancy (r = 0.388; P < 0.001), but just borderline with endometrial thickness (r = 0.294; P = 0.05). The area under the curve was highest for kisspeptin, 0.784 (95% CI, 0.681 to 0.886) for positive pregnancy, which indicated that kisspeptin measured on HCG day can be used as a marker for success of treatment in women after ICSI.
2014年6月至2015年6月期间,在澳大利亚概念不孕不育医疗中心开展了一项横断面研究,以探讨人绒毛膜促性腺激素(HCG)日的血清亲吻素水平与卵胞浆内单精子注射(ICSI)后妊娠结局之间的关系。共有176名年龄在20至42岁之间、月经周期规律、甲状腺功能和催乳素水平正常且被选进行ICSI的女性纳入研究。排除患有子宫肌瘤、代谢紊乱、采用短方案激动剂和拮抗剂方案的患者。观察采用长方案进行卵巢降调节,并在HCG日评估亲吻素水平。结果分为两组:A组,β-HCG<25 mIU/ml未妊娠;B组,β-HCG>25 mIU/ml且经阴道扫描有胎心搏动的临床妊娠。B组的亲吻素水平显著高于A组(P<0.001),与妊娠阳性独立相关(r=0.388;P<0.001),但与子宫内膜厚度仅为临界相关(r=0.294;P=0.05)。亲吻素的曲线下面积最高,妊娠阳性的曲线下面积为0.784(95%CI,0.681至0.886),这表明在HCG日测量的亲吻素可作为ICSI后女性治疗成功的标志物。