骨形态蛋白(BMP)-15对子宫内膜异位症患者IVF结局影响的临床研究  

Influence of Bone Morphogenetic Protein(BMP)-15 on the IVF Outcomes of Endometriosis——A Clinical Trail and Experimental Research

作　　者：张永美[1] 林小娜[1] 周枫[1] 尉敏龄[1] 张松英[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院生殖中心,杭州300016

出　　处：《生殖与避孕》2012年第11期739-743,753,共6页Reproduction and Contraception

基　　金：浙江省自然科学基金项目;项目号:Y208505

摘　　要：目的:探索卵丘颗粒细胞早期凋亡和骨形态蛋白-15(bone morphogenetic protein-15,BMP-15)对子宫内膜异位症(EMs)患者IVF结局的影响。方法:行体外受精-胚胎移植(IVF-ET)的不孕患者,根据不孕指征分为EMs组及对照组。分别记录患者一般情况、获卵数、正常受精卵数、卵裂数、优质胚胎数、胚胎种植数和临床妊娠率。流式细胞仪测定所有对象卵丘颗粒细胞的早期凋亡率,Western blotting检测卵泡液中BMP-15蛋白的表达量。结果:获卵率、受精率、卵裂率、优质胚胎率差异无统计学意义(P>0.05);EMs组与对照组相比,获卵数分别为8.2±5.7个和12.0±5.8个,着床率分别为29.73%和47.31%,临床妊娠率分别43.37%和69.32%,差异均有统计学意义(P<0.05)。EMs组卵丘颗粒细胞的早期凋亡率为37.82±15.81%,对照组为8.85±5.58%,差异具有统计学意义(P<0.01)。卵泡液中BMP-15蛋白相对表达量EMs组为0.67±0.18,对照组0.94±0.33,差异有统计学意义(P<0.05)。结论:EMs患者IVF着床率及临床妊娠率降低,可能与卵母细胞分泌较少的BMP-15、颗粒细胞早期凋亡率增加,影响卵母细胞质量和胚胎的正常发育有关。Objective： To investigate the effects of the bone morphogenetic protein-15 （BMP-15） and the apoptosis rate of granulosa cells on IVF outcomes of infertile patients with endometriosis （EMs）. Methods： The infertile patients undergoing IVF-ET were divided into EMs group and control group according to infertility indications. The general information, oocyte number, fertilization number, normal embryo, high-quality embryo number, implan- tation number and pregnancy rate were recorded. The apoptosis rate of granulocyte and the content of BMP-15 in follicular fluid between EMs group and the control were determined by flow cytometry and Western blotting, respectively. Results： The rate of oocytes retrieved, the fertilization rate, the cleavage rate, the high-quality embryo rate between the two groups did not have significant differences （P〉0.05）. The oocytes number, the pregnancy rate of the patients with EMs were 8.2 ± 5.7, 43.37%, while they were 12.0 ± 5.8, 69.32% in the control. The oocytes number, the implan- tation rate, the pregnancy rate had a significant difference between the two groups （P〈0.05）. The apoptosis rate was 37.82 ± 15.81% in EMs group and 8.85 ± 5.58% in the control. The apoptosis rate in EMs group was high than that in the control, there was significant difference between these two groups （P〈0.01）. The content of BMP-15 in follicular fluid was 0.67 ±0.18 in EMs group and 0.94 ± 0.33 in the control, there was a significant difference between these two groups （P〈0.05）. Conclusion： The expression of BMP-15 in follicular fluid of the EMs patients was fewer than the control. That maybe increase the apoptosis rate of the granulosa cells, then affect the quality of oocytes and the development of embryo. All of these will decrease implantation rate and the pregnancy rate.

关 键 词：子宫内膜异位症(EMs) 颗粒细胞 骨形态发生蛋白-15(BMP-15) 凋亡 IVF-ET 

分 类 号：R714.8[医药卫生—妇产科学]