Tong Jing, Sheng Shile, Sun Yun, Li Huihui, Li Wei-Ping, Zhang Cong, Chen Zi-Jiang
Center for Reproductive MedicineRen Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Shanghai Key Laboratory for Assisted Reproduction and Reproductive GeneticsShanghai, China.
Reproduction. 2017 Apr;153(4):443-451. doi: 10.1530/REP-16-0641. Epub 2017 Jan 6.
Good-quality oocytes are critical for the success of in vitro fertilization (IVF), but, to date, there is no marker of ovarian reserve available that can accurately predict oocyte quality. Melatonin exerts its antioxidant actions as a strong radical scavenger that might affect oocyte quality directly as it is the most potent antioxidant in follicular fluid. To investigate the precise role of endogenous melatonin in IVF outcomes, we recruited 61 women undergoing treatment cycles of IVF or intracytoplasmic sperm injection (ICSI) procedures and classified them into three groups according to their response to ovarian stimulation. Follicular fluid was collected to assess melatonin levels using a direct RIA method. We found good correlations between melatonin levels in follicular fluid with age, anti-Müllerian hormone (AMH) and baseline follicle-stimulating hormone (bFSH), all of which have been used to predict ovarian reserve. Furthermore, as melatonin levels correlated to IVF outcomes, higher numbers of oocytes were collected from patients with higher melatonin levels and consequently the number of oocytes fertilized, zygotes cleaved, top quality embryos on D3, blastocysts obtained and embryos suitable for transplantation was higher. The blastocyst rate increased in concert with the melatonin levels across the gradient between the poor response group and the high response group. These results demonstrated that the melatonin levels in follicular fluid is associated with both the quantity and quality of oocytes and can predict IVF outcomes as well making them highly relevant biochemical markers of ovarian reserve.
优质卵母细胞对于体外受精（IVF）的成功至关重要，但迄今为止，尚无可用的卵巢储备标志物能够准确预测卵母细胞质量。褪黑素作为一种强大的自由基清除剂发挥其抗氧化作用，由于它是卵泡液中最有效的抗氧化剂，可能直接影响卵母细胞质量。为了研究内源性褪黑素在IVF结局中的精确作用，我们招募了61名接受IVF或卵胞浆内单精子注射（ICSI）程序治疗周期的女性，并根据她们对卵巢刺激的反应将她们分为三组。收集卵泡液，采用直接放射免疫分析法评估褪黑素水平。我们发现卵泡液中的褪黑素水平与年龄、抗苗勒管激素（AMH）和基础促卵泡激素（bFSH）之间存在良好的相关性，所有这些指标都已用于预测卵巢储备。此外，由于褪黑素水平与IVF结局相关，褪黑素水平较高的患者收集到的卵母细胞数量更多，因此受精的卵母细胞数量、受精卵分裂数量、第3天优质胚胎数量、获得的囊胚数量以及适合移植的胚胎数量都更高。在反应不良组和高反应组之间的梯度上，囊胚率随着褪黑素水平的升高而增加。这些结果表明，卵泡液中的褪黑素水平与卵母细胞的数量和质量均相关，并且可以预测IVF结局，使其成为卵巢储备高度相关的生化标志物。
