PCOS不孕患者卵泡液中4种氧化应激标志物水平对IVF-ET结局的影响  

Effects of four levels of oxidative stress biomarkers in follicular fluid on IVF-ET outcomes in the infertile patients with PCOS

作　　者：蒋莹 李亚敏 韩颖 JIANG Ying;LI Ya-min;HAN Ying(Chifeng College Affiliated Hospital,Chifeng 024000)

机构地区：[1]赤峰学院附属医院,赤峰024000

出　　处：《生殖医学杂志》2024年第10期1323-1331,共9页Journal of Reproductive Medicine

基　　金：内蒙古自治区高等学校科学技术研究项目(NJZY23034)。

摘　　要：目的探讨卵泡液中氧化应激(OS)生物标志物对多囊卵巢综合征(PCOS)患者行IVF-ET妊娠结局的影响。方法收集2022年1—12月在我院行IVF-ET助孕治疗的109例不孕患者为研究对象。根据不孕原因将研究对象分为PCOS组(56例)和输卵管因素组(TF组,53例);又根据稳态评估胰岛素抵抗指数(HOMA-IR)将PCOS组分为合并IR组(PCOS-IR组,32例)和未合并IR组(PCOS-NIR组,24例)。比较PCOS组和TF组患者的一般资料、卵泡液中OS标志物[活性氧(ROS)、总抗氧化能力(TAC)、蛋白质羰基(PrC)和8-异前列烷(8-IP)]水平、获卵情况及妊娠结局;比较PCOS组和TF组、PCOS-IR组和PCOS-NIR组及各组不同分层亚组间卵泡液中OS标志物水平;采用Spearman相关性分析OS标志物与IVF-ET观察指标之间的相关性。结果(1)PCOS组和TF组患者间年龄、不孕年限和体质量指数(BMI)比较均无显著差异(P>0.05);PCOS组的基础窦卵泡计数(AFC)和抗苗勒管激素(AMH)水平显著高于TF组(P<0.05)。PCOS组的卵泡数、获卵数显著高于TF组(P<0.05);两组间卵裂率、优质胚胎率、持续妊娠率及流产率比较均无显著差异(P>0.05)。(2)PCOS组患者卵泡液中的8-IP和PrC水平显著高于TF组(P<0.05);两组间卵泡液ROS和TAC水平无显著性差异(P>0.05)。PCOS组和TF组中不同获卵数、卵裂率、胚胎等级亚组间OS标志物水平均无显著差异(P>0.05)。PCOS组中不同妊娠结局亚组(未妊娠、继续妊娠、流产)比较发现,流产亚组中卵泡液PrC和8-IP水平显著高于其他亚组(P<0.05);TF组中不同妊娠结局亚组间OS标志物水平均无显著差异(P>0.05)。PCOS-IR组的卵泡液PrC、ROS及8-IP水平显著高于PCOS-NIR组(P<0.05);PCOS-IR组和PCOS-NIR组中流产亚组的卵泡液PrC和8-IP水平显著高于未妊娠亚组和持续妊娠亚组(P<0.05)。(3)相关性分析发现,PCOS患者卵泡液中PrC、8-IP水平与IVF-ET流产率具有显著相关性(分别为r=0.61、0.69,P均<0.05)。结论OS可能对PCOS患者IVFObjective:To investigate the effect of oxidative stress(OS)biomarkers in follicular fluid on the pregnancy outcomes of PCOS patients undergoing IVF-ET.Method:A total of 109 infertile patients who underwent IVF-ET in Chifeng College Affiliated Hospital from January to December 2022 were recruited.According to the causes of infertility,the patients were divided into PCOS group(n=56)and fallopian tube factor group(TF group,n=53).Furthermore,according to the homeostasis assessment of insulin resistance index(HOMA-IR),the PCOS group was divided into a combined IR group(PCOS-IR group,n=32)and a non combined IR group(PCOS-NIR group,n=24).The general characteristics,oxidative stress(OS)markers in follicular fluid[reactive oxygen species(ROS),total antioxidant capacity(TAC),protein carbonyl(PrC),and 8-isoprostane(8-IP)],oocytes retrieval,and pregnancy outcomes were compared between the PCOS group and the TF group.The levels of OS markers in follicular fluid were compared between the PCOS group and the TF group,the PCOS-IR group and the PCOS-NIR group,as well as different stratified subgroups in each group.Spearman correlation analysis was used to examine the correlation between OS biomarkers and IVF-ET observation indicators.Results:There were no significant differences in the age of patients,infertility years,and body mass index(BMI)between the PCOS group and the TF group(P>0.05).The basal follicle count(AFC)and anti-Müllerian hormone(AMH)levels in the PCOS group were significantly higher than those in the TF group(P<0.05).The number of follicles and retrieved oocytes in the PCOS group was significantly higher than that in the TF group(P<0.05).There were no significant differences in the cleavage rate,high-quality embryo rate,ongoing pregnancy rate,and the miscarriage rate between the two groups(P>0.05).The levels of 8-IP and PrC in follicular fluid of PCOS group patients were significantly higher than those of TF group(P<0.05).There were no significant differences in ROS and TAC levels between the two groups(P>0.05).Th

关 键 词：多囊卵巢综合征 8-异前列烷 蛋白质羰基 氧化应激 体外受精-胚胎移植 

分 类 号：R711.6[医药卫生—妇产科学]