探讨体外受精-胚胎移植足月妊娠胎盘屏障的改变  

Investigation of the changes of placental barrier in full-term delivery after IVF-ET

作　　者：耿文君 管一春[2] 张丽 申小静 赵贝 严烩利 季清云 吴庆英 GENG Wen-jun;GUAN Yi-chun;ZHANG Li;SHEN Xiao-jing;ZHAO Bei;YAN Hui-li;JI Qing-yun;WU Qing-ying(Reproductive Center,Henan Reproductive&Obstetrics Hospital,Zhengzhou 450000;Reproductive Center,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450000)

机构地区：[1]河南省生殖妇产医院生殖中心,郑州450000 [2]郑州大学第三附属医院生殖中心,郑州450000

出　　处：《生殖医学杂志》2024年第6期792-797,共6页Journal of Reproductive Medicine

基　　金：国家重点研发计划(2021YFC2700602);河南省属科研院所基金(JBKY2023008)。

摘　　要：目的使用光镜及透射电镜探究经体外受精-胚胎移植(IVF-ET)助孕足月分娩的胎盘与自然妊娠足月分娩的胎盘的形态学改变。方法选择在郑州大学第三附属医院住院,经IVF-ET助孕分娩的6例胎盘为IVF-ET组,同期住院自然妊娠分娩的10例胎盘为对照组。两组均为足月、初产、无妊娠并发症、择期行剖宫产分娩病例。使用光镜观察两组胎盘中整体结构的改变,并使用透射电镜观察两组胎盘中超微结构的改变。结果IVF-ET组产妇年龄显著高于自然妊娠组[(32.8±1.9)岁vs.(26.7±2.9)岁,P<0.05],两组间孕周、母亲体质量指数(BMI)、新生儿出生体重、胎盘重量和胎盘效率比较均无显著性差异(P>0.05)。光镜下观察,IVF-ET组与自然妊娠组胎盘整体结构未见明显差异。透射电镜观察,与自然妊娠组胎盘相比,IVF-ET组胎盘屏障厚度[(3749.0±1514.0)μm vs.(3379.4±1080.6)μm]、合体滋养细胞基底膜厚度[(66.2±17.5)μm vs.(60.2±15.9)μm]、血管内皮细胞基底膜厚度[(104.2±23.4)μm vs.(103.5±21.9)μm]均呈增加趋势,但差异无统计学意义(P>0.05);IVF-ET组胎盘部分视野中可见到合体滋养细胞顶端微绒毛减少甚至缺失。结论IVF-ET技术并未造成胎盘大体结构上的明显改变,但其胎盘屏障厚度呈增厚趋势,合体滋养细胞顶端微绒毛减少,提示IVF-ET技术可能在一定程度上阻碍了胎儿与母体间的营养物质交换。Objective:To explore morphological changes of the placenta in full-term delivery after IVF-ET and natural full-term delivery by light microscopy and transmission electron microscopy.Methods:The placentas of 6 patients hospitalized in The Third Affiliated Hospital of Zhengzhou University were recruited in IVF-ET group and 10 patients hospitalized in the same period after natural conception were in the control group.Both of the two groups were full-term,without pregnancy complications and delivered by elective cesarean section.The gross structure and the ultrastructure of the placentas in the two groups were observed by light microscope and electron microscope,respectively.Results:The maternal age in IVF-ET group was significantly higher than that in the control group[(32.8±1.9)years vs.(26.7±2.9)years,P<0.05],and there were no significant differences in the gestational age,maternal body mass index(BMI),newborn birth weight,placental weight and placental efficiency between the two groups(P>0.05).Under light microscope,there was no significant difference in the overall structure of placenta between IVF-ET group and the control group.For transmission electron microscope observation,compared with the control group,the placental barrier thickness[(3749.0±1514.0)μm vs.(3379.4±1080.6)μm],zygotrophoblastic basement membrane thickness[(66.2±17.5)μm vs.(60.2±15.9)μm]and the thickness of basal membrane of vascular endothelial cells[(104.2±23.4)μm vs.(103.5±21.9)μm]were increased in IVF-ET group,but the differences were not statistically significant(P>0.05).In IVF-ET group,the apical microvilli of syncytiotrophoblast cells were reduced or even absent in the visual field of some placentas.Conclusions:IVF-ET technique did not cause significant change in the gross structure of placenta.However,the placental barrier thickness showed a tendency of thickening and the microvilli at the tip of syncytiotrophoblast cells decreased,suggesting that IVF-ET technology maybe hinder the exchange of nutrients between the fetus a

关 键 词：体外受精-胚胎移植 胎盘屏障 合体滋养细胞基底膜 血管内皮细胞基底膜 

分 类 号：R714.56[医药卫生—妇产科学]