体外受精-胚胎移植(IVF-ET)胚胎培养液中HLA-G检测在预测胚胎发育潜能和临床结局中的应用价值研究  

Correlation between HLA-G Detection in(IVF-ET)Embryo Culture Medium and Embryonic Development Potential and Clinical Outcome Abstract

作　　者：罗平[1] 沈开元[1] 卢娜[1] 罗江霞[1] 黄芬[1] 刘刚毅[1] LUO Ping;SHEN Kai-yuan;LU Na;LUO Jiang-xia;HUANG Fen;LIU Gang-yi(Reproductive Medicine Center,Liuzhou People’s Hospital,Guangxi Liuzhou 545006,China)

机构地区：[1]柳州市人民医院生殖医学科,广西柳州545006

出　　处：《现代检验医学杂志》2020年第6期163-166,186,共5页Journal of Modern Laboratory Medicine

基　　金：广西自然科学基金青年基金项目(2018GXNSFBA281048);广西壮族自治区卫健委课题(Z20170677)。

摘　　要：目的探讨培养液中可溶性人类白细胞抗原G(HLA-G)表达水平在预测胚胎发育潜能、评估临床结局中的应用价值。方法选取2017年12月~2019年8月在柳州市人民医院生殖医学科接受体外受精-胚胎移植(IVF-ET)治疗的不孕不育夫妇共156对,收集其胚胎培养第三天(D3)或第五天(D5)的培养上清液,检测培养液中HLA-G浓度。根据移植临床结局分为临床妊娠组和未妊娠组,根据移植胚胎培养液HLA-G浓度按D3卵裂期胚胎≥2.5U/ml或D5囊胚≥6.8U/ml分为高浓度组和低浓度组分别进行比较,同时对D3胚胎继续培养形成囊胚情况及不同级别囊胚培养液HLA-G含量进行比较分析。结果临床妊娠组和未妊娠组间的平均年龄、不孕年限、抗苗勒管激素(AMH)、子宫内膜厚度、平均获卵数、受精率、优质胚胎率比较差异均无统计学意义(均P>0.05),HLA-G浓度分别为7.38±4.12 U/ml和2.46±1.69 U/ml,两组比较差异有统计学意义(t=3.628,P<0.01);形成优质囊胚、可用囊胚和不可用囊胚培养液中的HLA-G浓度分别为12.36±5.27,8.15±3.69和5.62±3.10 U/ml,三组比较差异有统计学意义(t=2.856,P<0.05);HLA-G高浓度组临床妊娠率和胚胎种植率分别为69.41%(59/85)和49.60%(62/125),均高于HLA-G低浓度组46.05%(35/76)和26.78%(30/112),差异有统计学意义(χ2=9.011,12.946,均P<0.01),两组之间的生化妊娠率和流产率比较差异无统计学意义(χ2=0.527,0.368,均P>0.05)。结论检测胚胎培养液中HLA-G水平可作为胚胎发育潜能的预测指标,联合形态学评分进行胚胎移植可获得较好的临床结局。Objective To investigate the application value of soluble human leucocyte antigen G(sHLA-G)expression in culture medium in predicting embryo development potential and evaluating clinical outcome.Methods 156 infertile couples treated with in vitro fertilization-embryo transfer(IVF-ET)in the Department of Reproductive Medicine of Liuzhou People’s Hospital from December 2017 to August 2019 were selected to collect the culture supernatant from the third(D3)or fifth(D5)day of embryo culture and to detect the HLA-G concentration in the culture medium.The clinical pregnancy or non-pregnant group was divided according to the clinical outcome of transplantation.According to the HLA-G content in medium,HLA-G≥2.5 U/ml from day 3 embryo culture medium or HLA-G≥6.8 U/ml from day 5 blastocyst was regarded as HLA-G high group.HLA-G<2.5 U/ml from day 3 embryo culture medium or HLA-G<6.8 U/ml from day 5 blastocyst was regarded as HLA-G low group.The blastocyst formation rates and the HLA-G contents in culture medium from different grade blastocyst were compared.Results There was no significant difference in the mean age,infertile years,AMH,endometrial thickness,average number of oocytes retrieved,fertilization rate and high quality embryo rate between clinical pregnancy and non-pregnant groups(all P>0.05),but was statistically significant difference in HLA-G concentration from culture medium(t=3.628,P<0.01,7.38±4.12U/ml and 2.46±1.69U/ml,respectively).The HLA-G concentration in the culture medium from high quality blastocyst,available blastocyst and unavailable blastocyst groups were 12.36±5.27,8.15±3.69 and 5.62±3.10U/ml,respectively,which were significant differences(t=2.856,P<0.05).The clinical pregnancy rate and embryo implantation rate in HLA-G high group were 69.4%(59/85)and 49.6%(62/125),respectively,which significantly higher than those in HLA-G low group 46.05%(35/76)and 26.78%(30/112),respectively(χ2=9.011,12.946,P<0.01).No significant difference was found in biochemical pregnancy rate and abortion rate betw

关 键 词：体外受精-胚胎移植 胚胎培养上清液 可溶性人类白细胞抗原G 发育潜能 临床结局 

分 类 号：R394-33[医药卫生—医学遗传学]