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血管内皮生长因子与体外受精-胚胎移植/卵胞浆内单精子注射临床结局的相关性

Association between Vascular Endothelial Growth Factor and Clinical Outcomes of IVF-ET/ICSI.

作者信息

Chen Hui, Zheng Jian-Bo, Wang Dong-Mei, Xing Hua, Wang Hui

机构信息

Reproductive Medical Center, Yantaishan Hospital, Yantai, Shandong Province, 264000, China.

出版信息

J Coll Physicians Surg Pak. 2019 Jan;29(1):19-23. doi: 10.29271/jcpsp.2019.01.19.

Abstract

OBJECTIVE

To investigate the association between the level of vascular endothelial growth factor (VEGF) and the quality of early embryos as well as clinical outcome after embryo transplantation in embryo culture medium of patients treated with IVF-ET/ICSI, and explore the association between VEGF 936 C/T gene polymorphisms and IVF-ET/ICSI clinical outcomes.

STUDY DESIGN

Case-control study.

PLACE AND DURATION OF STUDY

The Reproductive Medical Center, Yantaishan Hospital, Yantai, Shandong Province, China, from January to December 2016.

METHODOLOGY

Ninety-eight patients undergoing IVF-ET/ICSI treatment were divided into pregnant group (n=58) and nonpregnant group (n=40), based on clinical outcomes. Average age, infertility duration, body mass index, number of previous grafts, basic follicle-stimulating hormone (FSH) levels, luteinizing hormone (LH) levels, chorionic gonadotropin (HCG) intimal thickness, estrogen (E2) levels, progesterone (P) levels, and other relevant indicators were compared between the two groups. The vascular endothelial growth factor (VEGF) levels in the embryo culture medium were detected by enzyme-linked immunosorbent assay (ELISA). Meanwhile, VEGF 936 C/T genotype and allele frequency (%) were compared between the two groups.

RESULTS

There was no significant difference in average age, infertility duration, number of previous grafts, basic folliclestimulating hormone (FSH) levels, luteinizing hormone (LH) levels, chorionic gonadotropin (HCG) intimal thickness, estrogen (E2) level, progesterone (P) level, number of retrieved oocytes, embryo number, quality embryo number, quality embryo rate, and cumulative embryo score (CES) of transplanted embryo between the two groups (P=0.601, 0.180, 0.741, 0.119, 0.693, 0.282, 0.064, 0.505, 0.712, 0.822, 0.663, 0.150, 0.178, 0.204 and 0.263, respectively). VEGF level in embryo culture medium was lower in pregnant group than non-pregnant group, with statistically significant difference (p<0.001). VEGF level in the culture medium of grade I embryos was significantly lower than that of grade II embryos (p<0.001). The frequencies of CC genotype and C allele in VEGF 936 in the non-pregnant group were higher than those in the pregnant group (p=0.003, and 0.005, respectively).

CONCLUSION

VEGF level in the embryo culture medium can be used as one reference indicator for predicting embryo quality and pregnancy outcome. The VEGF 936 C/T gene polymorphism may be related to IVF-ET/ICSI treatment outcome, and C allele may be a susceptibility gene for IVF-ET/ICSI failure.

摘要

目的

探讨体外受精-胚胎移植/卵胞浆内单精子注射(IVF-ET/ICSI)治疗患者胚胎培养液中血管内皮生长因子(VEGF)水平与早期胚胎质量及胚胎移植后临床结局的关系,并探讨VEGF 936 C/T基因多态性与IVF-ET/ICSI临床结局的关系。

研究设计

病例对照研究。

研究地点和时间

中国山东省烟台市烟台山医院生殖医学中心,2016年1月至12月。

方法

将98例行IVF-ET/ICSI治疗的患者根据临床结局分为妊娠组(n=58)和未妊娠组(n=40)。比较两组患者的平均年龄、不孕年限、体重指数、既往移植次数、基础卵泡刺激素(FSH)水平、黄体生成素(LH)水平、绒毛膜促性腺激素(HCG)内膜厚度、雌激素(E2)水平、孕酮(P)水平及其他相关指标。采用酶联免疫吸附试验(ELISA)检测胚胎培养液中血管内皮生长因子(VEGF)水平。同时,比较两组患者VEGF 936 C/T基因型及等位基因频率(%)。

结果

两组患者的平均年龄、不孕年限、既往移植次数、基础卵泡刺激素(FSH)水平、黄体生成素(LH)水平、绒毛膜促性腺激素(HCG)内膜厚度、雌激素(E2)水平、孕酮(P)水平、获卵数、胚胎数、优质胚胎数、优质胚胎率及移植胚胎的累积胚胎评分(CES)比较,差异均无统计学意义(P值分别为0.601、0.180、0.741、0.119、0.693、0.282、0.064、0.505、0.712、0.822、0.663、0.150、0.178、0.204和0.263)。妊娠组胚胎培养液中VEGF水平低于未妊娠组,差异有统计学意义(p<0.001)。Ⅰ级胚胎培养液中VEGF水平显著低于Ⅱ级胚胎(p<0.001)。未妊娠组VEGF 936中CC基因型和C等位基因频率高于妊娠组(p值分别为0.003和0.005)。

结论

胚胎培养液中VEGF水平可作为预测胚胎质量和妊娠结局的参考指标之一。VEGF 936 C/T基因多态性可能与IVF-ET/ICSI治疗结局有关,C等位基因可能是IVF-ET/ICSI失败的易感基因。

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