脱氢表雄酮对卵巢储备功能下降患者颗粒细胞WNT/CTNNB1通路及IVF结果的影响  

Effect of dehydroepiandrosterone on WNT/CTNNB1 pathway in granular cells and in vitro fertilization outcomes among patients with diminished ovarian reserve

作　　者：何珊[1] 刘大艳[2] 朱文杰[2] 付志红[2] 李雪梅[2] 林碎玲[2] 张婉菁[2] 

机构地区：[1]深圳市妇幼保健院药剂科,广东深圳518028 [2]深圳市妇幼保健院生殖医学中心,广东深圳518028

出　　处：《中国妇幼保健》2017年第13期2959-2963,共5页Maternal and Child Health Care of China

基　　金：广东省科技计划项目(A2013595);深圳市知识创新计划基础研究项目(JCYJ20140414145551269)

摘　　要：目的探讨脱氢表雄酮(DHEA)预治疗对卵巢储备功能下降(DOR)患者颗粒细胞WNT/CTNNB1通路相关信号分子及体外授精-胚胎移植(IVF-ET)结果的影响。方法选择进入IVF周期DOR的不孕患者9例为研究对象,比较分析DHEA预治疗前后IVF结果及卵巢颗粒细胞AKT、CTNNB1蛋白、WNT2 mRNA、CYP19A1 mRNA相对表达量。结果与既往IVF周期比较,DHEA预治疗后基础窦卵泡数目(AFC)显著增加,基础卵泡刺激素(FSH)、FSH/LH的水平明显降低,黄体生成素(LH)水平升高,两组之间比较差异有统计学意义(P<0.05);DHEA预治疗后人绒毛膜促性腺激素(h CG)日雌二醇(E2)水平、获卵数、MⅡ卵子数、优质胚胎数显著提高(P<0.05);DHEA预治疗后AKT相对表达量降低、CTNNB1蛋白和CYP19A1mRNA相对表达量升高,差异有统计学意义(P<0.05)。结论 IVF治疗过程中,对DOR女性进行DHEA预治疗,可通过作用于WNT/CTNNB1通路相关信号分子改善卵巢微环境,进而提高卵巢的储备功能及反应性,改善IVF结果。Objective To explore the effect of pretreatment with dehydroepiandrosterone（DHEA） on WNT/CTNNB1 pathway-related signaling molecules in granular cells and the outcomes of in vitro fertilization-embryo transfer（IVF-ET） among patients with diminished ovarian reserve（DOR）.Methods Nine infertile patients with DOR entering into IVF cycle were selected as study objects.The relative expression levels of AKT protein,CTNNB1 protein,WNT2 mRNA,and CYP19A1 mRNA and IVF outcomes before and after pretreatment with DHEA were compared and analyzed.Results Compared with previous IVF cycles,the basal antral follicle count（AFC） significantly increased after pretreatment with DHEA,the level of basal follicle stimulating hormone（FSH） and FSH/luteinizing hormone（FSH/LH） obviously decreased after pretreatment with DHEA,the level of LH increased,there were statistically significant differences between the two groups（P〈0.05）.The level of estradiol increased on the day of human chorionic gonadotrophin（h CG） injection,the numbers of retrieved oocytes,the numbers of MⅡoocytes and high-quality embryo increased after pretreatment with DHEA,and there were statistically significant differences（P〈0.05）.After pretreatment with DHEA,the relative expression level of AKT decreased,CYP19A1 mRNA and CTNNB1 protein increased,there were statistically significant differences（P〈0.05）.Conclusion In the course of IVF,DOR patients pretreated with DHEA can improve the microenvironment of ovary by acting on WNT/CTNNB1 pathway-related signaling molecules.What＇ s more,ovarian reserve function,responsiveness and IVF outcomes are improved.

关 键 词：脱氢表雄酮 卵巢储备功能下降 体外受精-胚胎移植 颗粒细胞 

分 类 号：R711.75[医药卫生—妇产科学]