Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan.
Medical College, Aga Khan University, Karachi, Pakistan.
PLoS One. 2020 Oct 28;15(10):e0239142. doi: 10.1371/journal.pone.0239142. eCollection 2020.
To relate serum and follicular fluid (FF) kisspeptin and estradiol levels in different stages of stimulation during Intracytoplasmic Sperm Injection (ICSI) with oocyte maturity and endometrial thickness among unexplained infertile females.
This cross-sectional study was carried out at the Australian Concept Infertility Medical Centre from March 2017 till March 2018. Fifty unexplained infertile females, booked for ICSI, were included in the study. Serum kisspeptin and estradiol were estimated by Enzyme-Linked Immunosorbent Assay in all four stages; 1: follicular stimulation, 2: ovulation induction, 3: oocyte pickup, and 4: embryo transfer. FF was aspirated during oocyte retrieval (stage 3) for the analysis of KP and estradiol. Pregnancy outcomes were categorized as non-pregnant, preclinical abortion, and clinical pregnancy.
The age of the study subjects was 32.04 ± 2.29 (Mean±SD) years, with mean BMI of 28.51 ± 4.15 (Mean±SD) kg/m2. Mean serum kisspeptin and estradiol levels increased in all subjects as the stimulation proceeded stages 1-3; however, the mean dropped after retrieval of the oocytes (stage 4). Out of 27 female subjects who completed the cycle, 17 remained non-pregnant, 4 had preclinical abortion, and 6 acquired clinical pregnancy. The FF kisspeptin concentration was significantly higher than serum concentrations and positively correlated with serum and FF estradiol concentrations. FF-kisspeptin correlated with serum kisspeptin in Stage 3 (r = 0.930, p<0.001), maturity of oocyte (r = 0.511, p = 0.006) and endometrial thickness (r = 0.522, p = 0.005). Kisspeptin in stage 3 was also found to correlate with endometrial thickness (r = 0.527, p = 0.005) and with estradiol (r = 0.624, p = 0.001) independently.
Increase in serum and FF-kisspeptin and estradiol levels from stages 1 to 3, resulted in an optimum endometrial thickness, probability of fertilization of oocytes and chances of clinical pregnancy in Assisted Reproductive Techniques /ICSI cycles of unexplained infertile females.
研究不明原因不孕女性卵胞浆内单精子注射（ICSI）过程中，血清和卵泡液（FF） kisspeptin 和雌二醇水平在不同刺激阶段与卵母细胞成熟和子宫内膜厚度的关系。
本横断面研究于 2017 年 3 月至 2018 年 3 月在澳大利亚概念不孕不育医学中心进行。共纳入 50 名接受 ICSI 的不明原因不孕女性。采用酶联免疫吸附法（ELISA）检测所有 4 个阶段（1：卵泡刺激、2：排卵诱导、3：卵母细胞采集和 4：胚胎移植）的血清 kisspeptin 和雌二醇水平。在卵母细胞采集（第 3 阶段）时抽吸 FF 以分析 KP 和雌二醇。妊娠结局分为未妊娠、临床前流产和临床妊娠。
研究对象的年龄为 32.04±2.29（均值±标准差）岁，平均 BMI 为 28.51±4.15（均值±标准差）kg/m2。随着刺激阶段 1-3 的进行，所有受试者的血清 kisspeptin 和雌二醇水平均升高，但在卵母细胞采集（第 4 阶段）后，平均值下降。在完成周期的 27 名女性中，17 名未妊娠，4 名临床前流产，6 名获得临床妊娠。FF-kisspeptin 浓度明显高于血清浓度，与血清和 FF 雌二醇浓度呈正相关。FF-kisspeptin 与第 3 阶段的血清 kisspeptin 相关（r=0.930，p<0.001）、卵母细胞成熟度（r=0.511，p=0.006）和子宫内膜厚度（r=0.522，p=0.005）相关。第 3 阶段的 kisspeptin 还与子宫内膜厚度（r=0.527，p=0.005）和雌二醇（r=0.624，p=0.001）独立相关。
在不明原因不孕女性的辅助生殖技术/ICSI 周期中，从第 1 阶段到第 3 阶段，血清和 FF-kisspeptin 及雌二醇水平升高，导致最佳的子宫内膜厚度、卵母细胞受精概率和临床妊娠机会。
