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供卵体外受精妊娠中孕期母血清血管生成标志物水平。

Levels of angiogenic markers in second-trimester maternal serum from in vitro fertilization pregnancies with oocyte donation.

机构信息

University of Louisville School of Medicine, Louisville, Kentucky.

University of Louisville School of Medicine, Louisville, Kentucky.

出版信息

Fertil Steril. 2019 Dec;112(6):1112-1117. doi: 10.1016/j.fertnstert.2019.07.017.

Abstract

OBJECTIVE

To determine whether differences exist in angiogenic placental growth factor (PlGF) and antiangiogenic soluble vascular endothelial growth factor receptor 1 (sVEGFR-1; both being early markers of placental ischemic disease) in oocyte-donation (OD) pregnancies, compared with autologous in vitro fertilization (aIVF) and spontaneous pregnancies.

DESIGN

Case-control study of residual second-trimester serum samples from women undergoing prenatal screening.

SETTING

Academic medical center.

PATIENT(S): Fifty-seven OD pregnancies were identified. Each OD pregnancy was matched to two spontaneous pregnancies (n = 114) and one aIVF pregnancy (n = 57).

INTERVENTIONS(S): None.

MAIN OUTCOME MEASURE(S): Second-trimester serum PlGF and sVEGFR-1 levels.

RESULT(S): sVEGFR-1, PlGF, and unconjugated E levels were similar among the three study groups. The ratio of sVEGFR-1 to PlGF was significantly higher in the OD group. Consistently with previous studies, alpha-fetoprotein (AFP) in the OD group was significantly elevated compared with spontaneous pregnancy. Both aIVF and OD groups had greater levels of inhibin A than the spontaneous pregnancy group, and the OD group had significantly higher levels of inhibin A than the aIVF group. hCG levels were significantly elevated in aIVF compared with spontaneous pregnancy; however, levels were not different between aIVF and OD.

CONCLUSION(S): Second-trimester serum sVEGFR-1 and PlGF levels were not significantly altered in OD pregnancies. Our data support previous findings that OD pregnancies have uniquely increased second-trimester AFP, hCG, and inhibin A levels compared with aIVF. However, the biologic basis of these marker elevations in OD may not be related to placental angiogenesis.

摘要

目的

比较卵母细胞捐赠(OD)妊娠与自体体外受精(aIVF)和自然妊娠,胎盘血管生成因子(PlGF)和抗血管生成可溶性血管内皮生长因子受体 1(sVEGFR-1;两者均为胎盘缺血性疾病的早期标志物)是否存在差异。

设计

对接受产前筛查的女性的残留中期血清样本进行病例对照研究。

地点

学术医疗中心。

患者

确定了 57 例 OD 妊娠。每例 OD 妊娠均与 2 例自然妊娠(n=114)和 1 例 aIVF 妊娠(n=57)相匹配。

干预措施

无。

主要观察指标

中孕期血清 PlGF 和 sVEGFR-1 水平。

结果

三组研究中 sVEGFR-1、PlGF 和未结合 E 水平相似。OD 组 sVEGFR-1 与 PlGF 的比值明显高于其他两组。与之前的研究一致,OD 组的甲胎蛋白(AFP)水平明显高于自然妊娠组。aIVF 和 OD 组的抑制素 A 水平均高于自然妊娠组,而 OD 组的抑制素 A 水平明显高于 aIVF 组。与自然妊娠相比,aIVF 组的 hCG 水平明显升高;然而,aIVF 和 OD 组之间的 hCG 水平没有差异。

结论

OD 妊娠中孕期血清 sVEGFR-1 和 PlGF 水平无明显改变。我们的数据支持之前的研究结果,即与 aIVF 相比,OD 妊娠具有独特的中孕期 AFP、hCG 和抑制素 A 水平升高。然而,OD 中这些标志物升高的生物学基础可能与胎盘血管生成无关。

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