子宫内膜异位症不孕妇女腹腔液对精子运动及穿卵的影响  

Effects of peritoneal fluid of infertile women with endometriosis on human sperm motility and the zone-free hamster oocyte penetration test

作　　者：曹文丽[1] 叶玲玲[1] 索永善[1] 孙运明[1] 施晓[1] 陈美[1] 

机构地区：[1]浙江省舟山市妇幼保健院生殖医学中心,316000

出　　处：《中国优生与遗传杂志》2010年第5期119-120,137,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨子宫内膜异位症(内异症)性不孕妇女的腹腔液对人精子运动及穿卵率的影响。方法将行诊断性腹腔镜检查的不孕妇女40例分为内异症组20例,根据r-AFS分期:早期(Ⅰ?Ⅱ)12例,晚期(Ⅲ?Ⅳ)8例,对照组20例为其它原因不孕者,酶标双抗体夹心法(ELISA)测定两组患者腹腔液肿瘤坏死因子(TNF-α)的含量;正常人精液按1∶1比例和两组腹腔液共同孵育,测定精子运动参数(平均曲线速度、平均直线速度、平均路径速度、直线前向运动百分率)和去透明带地鼠卵穿透试验的变化。结果内异症组腹腔液TNF-α含量高于其它原因不孕组(P<0.05),且晚期内异症组的TNF-α又明显高于早期患者(P<0.05);内异症组四项精子运动参数指标均低于对照组,与TNF-α含量呈负相关(P<0.05);内异症组穿卵数值明显低于对照组(P<0.05)。结论体外观察内异症不孕患者腹腔液对精子活力及穿卵受精能力有明显抑制作用,内异症患者腹腔液内TNF-α值升高与疾病程度正相关,可能是导致不孕的机理之一。Objective ： To investigate the effect of peritoneal fluid of infertile women with endometriosis on human sperm motility and zone - free hamster oocyte penetration test. Methods ： A Prospective study was conducted to include 40 infertile women with （ n = 20） and without （n =20） histopathologically confirmed endometriosis by laparoscope, Based on r- AFS classification, stage Ⅰ / Ⅱ and stage Ⅲ / Ⅳ were categorized as early and late - staged endometriosis. The level of TNF - α were detected in this two groups by enzyme linked immunoassay （ELISA） ; Sperm motility, motion characteristics and the zone -free hamster oocyte penetration test were also studied in vitro. Results： The level of TNF -α in peritoneal fluid of endometriosis group was higher than the control （ P 〈 0. 05 ）, and the level of TNF - α in peritoneal fluid of endometriosis was significantly higher in late - staged than those in early - staged （ P 〈 0. 05） ; Four parameter of sperm movement （ VCL, VSL, VAP, MOT） in endometriosis group significantly differed control group, The level of TNF -α in peritoneal fluid of endometriosis had negative correlation with the sperm motility and motion characteristics （ P 〈 0.05） ; The rate of oocytes penetrated in the sperm mixed with peritoneal fluid of emdometriosis group was significantly smaller than that in the control group. Conclusions ： The peritoneal fluid of infertile women with endometriosis could contribute to infertility by inhibitioning the sperm motility and sperm fertility, The level of TNF - α in peritoneal fluid of endometriosis patients was increased, and there was positive correlation with the endometriosis aggravated, it is considered to be a significant pelvic mediator of female sterility.

关 键 词：子宫内膜异位症 腹腔液 肿瘤坏死因子 精子运动参数 精子穿透试验 

分 类 号：R711.71[医药卫生—妇产科学]