Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China.
Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, China.
Int J Gynaecol Obstet. 2021 Oct;155(1):138-145. doi: 10.1002/ijgo.13581. Epub 2021 Apr 13.
In this study, we investigated the effect of thyroid-stimulating hormone (TSH) level on the outcomes of in vitro fertilization (IVF) in patients with polycystic ovary syndrome (PCOS).
Data pertaining to 60 patients who underwent IVF between May 2017 and May 2018 were included in the study. Thirty-two patients were diagnosed as PCOS (PCOS group) and 28 patients had tubal infertility (control group). Serum and follicular fluid TSH levels and follicular cyclic AMP (cAMP) level were detected by ELISA. TSH receptor (TSHR) expression level in granulosa cells was quantified by RT-PCR and Western blot.
In the PCOS group, oocyte maturation rate and fertilization rate were significantly lower than in the control group. Serum and follicular fluid TSH levels and ovarian cAMP level were higher in the PCOS group with an upregulation of ovarian TSHR. On multivariate linear regression analysis, fertilization rate showed a negative correlation with TSH levels in serum (B = -0.106, P = 0.005) and follicular fluid (B = -0.107, P = 0.001).
In PCOS patients, TSH levels, both in serum and follicular fluid, were negatively correlated with IVF oocyte maturation rate and fertilization rate. The effect of TSH on controlled ovarian hyperstimulated oocyte growth was likely mediated by the TSHR/cAMP signaling pathway.
本研究旨在探讨促甲状腺激素（TSH）水平对多囊卵巢综合征（PCOS）患者体外受精（IVF）结局的影响。
纳入 2017 年 5 月至 2018 年 5 月期间接受 IVF 的 60 例患者的数据。其中 32 例患者被诊断为 PCOS（PCOS 组），28 例患者患有输卵管性不孕（对照组）。通过 ELISA 检测血清和卵泡液 TSH 水平和卵泡环磷酸腺苷（cAMP）水平。通过 RT-PCR 和 Western blot 定量检测颗粒细胞中 TSH 受体（TSHR）的表达水平。
在 PCOS 组中，卵母细胞成熟率和受精率明显低于对照组。PCOS 组血清和卵泡液 TSH 水平以及卵巢 cAMP 水平升高，卵巢 TSHR 表达上调。多元线性回归分析显示，受精率与血清（B=-0.106，P=0.005）和卵泡液（B=-0.107，P=0.001）中的 TSH 水平呈负相关。
在 PCOS 患者中，血清和卵泡液中的 TSH 水平与 IVF 卵母细胞成熟率和受精率呈负相关。TSH 对控制性卵巢过度刺激卵母细胞生长的影响可能是通过 TSHR/cAMP 信号通路介导的。
