Khadem Nayyereh, Mansoori Mahsa, Attaran Matin, Attaranzadeh Armin, Zohdi Elnaz
Department of Obstetrics and Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Obstetrics and Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran. Elevtronic Address:
Int J Fertil Steril. 2019 Oct;13(3):236-239. doi: 10.22074/ijfs.2019.5668. Epub 2019 Jul 14.
In this work, we have determined the levels of interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF-α), which function as cytokines in endometrial receptivity, through the endometrial secretion within the eligible individuals and thus studied their relationships with the success or failure of pregnancy in fertilization/intra cytoplasmic sperm injection (IVF/ICSI) cycles.
In this prospective study, 76 women were selected for their first IVF/ICSI and met the study inclusion criteria. All of the patients have undergone the endometrial secretion aspiration prior to performing the oocyte collection. The levels of IL-1and TNF-α were analyzed by the means of enzyme-linked immunosorbent assay method, using special standard kits. The patients were requested to undergo the serum human chorionic gonadotropin measurements and ultrasound evaluation for the purpose of detecting successful implantations and pregnancies.
Among the 76 subjects of the study, 33 (43.4%) patients had a positive beta-human chorionic gonadotropin (β-hCG) and 44 (56.6%) resulted in a negative β-hCG. It should be also noted that through the patients with positive β-hCG, 23 (30.3%) of them displayed fetal heart rate in their transvaginal sonography (TVS). Compared to the group with failed pregnancies and their cytokine levels, we perceived a higher concentration of IL-1 in the group containing successful chemical pregnancies (P=0.00). However, there was no significant difference in terms of clinical pregnancy in the IL-1 levels between the two groups (P=0.06). In addition, there was not any notable difference in the levels of TNF-α between the two groups, neither in terms of chemical nor clinical pregnancy (P=0.8 and P=0.6, respectively).
The current study suggests that higher concentrations of IL-1 in endometrial secretions could be associated with improved endometrial receptivity and IVF outcome. With regards to TNF-α, no statistically significant difference was observed between the groups of with and without successful pregnancies.
在本研究中，我们通过符合条件个体的子宫内膜分泌物测定了白细胞介素-1（IL-1）和肿瘤坏死因子-α（TNF-α）的水平，它们作为细胞因子在子宫内膜容受性中发挥作用，从而研究了它们与体外受精/卵胞浆内单精子注射（IVF/ICSI）周期妊娠成败的关系。
在这项前瞻性研究中，选择76名首次进行IVF/ICSI且符合研究纳入标准的女性。所有患者在进行卵母细胞采集前均进行了子宫内膜分泌物抽吸。使用特殊标准试剂盒，通过酶联免疫吸附测定法分析IL-1和TNF-α的水平。要求患者进行血清人绒毛膜促性腺激素测量和超声评估，以检测是否成功着床和妊娠。
在该研究的76名受试者中，33名（43.4%）患者β-人绒毛膜促性腺激素（β-hCG）呈阳性，44名（56.6%）患者β-hCG呈阴性。还应注意的是，在β-hCG呈阳性的患者中，23名（30.3%）在经阴道超声检查（TVS）中显示有胎心。与妊娠失败组及其细胞因子水平相比，我们发现在化学妊娠成功组中IL-1浓度更高（P = 0.00）。然而，两组间IL-1水平在临床妊娠方面无显著差异（P = 0.06）。此外，两组间TNF-α水平在化学妊娠和临床妊娠方面均无显著差异（分别为P = 0.8和P = 0.6）。
当前研究表明，子宫内膜分泌物中较高浓度的IL-1可能与改善子宫内膜容受性和IVF结局相关。关于TNF-α，妊娠成功组和未成功组之间未观察到统计学上的显著差异。
