多囊卵巢综合征患者卵泡液LIF、IL-1β及性激素水平与IVF-ET结局关系的研究

目的:探讨多囊卵巢综合征(PCOS)患者卵泡液中白血病抑制因子(LIF)、白细胞介素-1β(IL-1β)及性激素水平与IVF-ET结局的关系。方法:用酶联免疫双抗夹心法和时间分辨免疫荧光法前瞻性研究了行IVF-ET的11例PCOS患者、14例对照组患者卵泡液中IL-1β、LIF及雌二醇(E2)和孕酮(P)的定量表达。结果:PCOS组卵泡液中LIF为21.1±11.1pg/mL,P为191.9×103nmol/L,明显低于对照组(33.5±11.8pg/mL,305.9×103nmol/L,P<0.05);而PCOS组卵泡液IL-Iβ为39.9±11.5pg/mL,E2浓度为3334.00nmol/L,明显高于对照组(28.3±10.6pg/mL,2138.1nmol/L),P<0.05。PCOS组胚胎种植率为8.8%,临床妊娠率为18.2%,明显低于对照组(16.7%,42.9%),P<0.05;PCOS组OHSS发生率为27.3%,明显高于对照组(7.1%,P<0.05)。LIF与E2在两组患者呈负相关(r=-0.442,P=0.027)、LIF与LH/FSH比值在PCOS组呈负相关(r=-0.682,P=0.021);IL-Iβ与E2在PCOS组呈正相关(r=0.612,P=0.045);LH/FSH比值与P在PCOS组呈负相关(r=-0.780,P=0.005);LIF与IL-Iβ水平两者间无明显相关性。结论:LIF可能是PCOS患者低种植率的关键因子;IL-Iβ可能是PCOS患者在控制性超排卵过程中易发生OHSS的一个致病因子;卵泡液IL-Iβ、LIF受卵巢激素调控。

Research on Relationships between IL-1β, LIF, Sex Hormone in Follicle Fluild and IVF-ET Outcomes in PCOS Patients

Objective: To investigate the relationships between IL-1β, LIF, sex hormone in follicular fluid and the IVF-ET outcomes. Methods: The enzyme-linked immunosorbent assay (ELISA) was used to quantify IL- 1β, LIF and the time-resolved fluoroimmunoassay was used to determine concentrations of estradiol (E2) and progesterone (P) in follicular fluid of 11 PCOS patients and 14 infertility patients. Results: The concentration of LIF and P in follicular fluid of PCOS group were 21.1±11.1 pg/mL and 191.9×103nmol/L, significantly lower than that in control group (33.5 ± 11.8 pg/mL and 305.9 × 103nmol/L, P<0.05). The concentration of IL-1β and E2in follicular fluid of PCOS group were 39.9±11.5 pg/mL and 3 334.0 nmol/L, significantly higher than that in control group (28.3±10.6 pg/mL and 2 138.1 nmol/L, P<0.05). The implantation rate and the clinical pregnancy rate in PCOS group (8.8% and 18.2%) were significantly lower than that in control group (16.7% and 42.9%, P<0.05).The OHSS rate is significantly higher in PCOS group (27.3%) than that in control group (7.1%). The level of LIF in follicular fluid was negatively correlated with E2 in both groups (r = -0.442, P =0.027). The level of LIF in follicular fluid was negatively correlated with LH/FSH ratio in PCOS group (r = -0.682, P =0.021). The level of IL-1β in follicular fluid was positively correlated with the level of E2 in PCOS group (r =0.612, P =0.045). LH/FSH ratio was negatively correlated with progesterone in PCOS group (r = -0.780, P =0.005). The level of LIF was not correlated with IL-1β. Conclusion: LIF may be a key factor for the decrease of embryo implantation rate. The high level of IL-1 β in follicular fluid of PCOS patients may be the pathogenic factor for OHSS. The level of LIF and IL-1β in follicular fluid may be regulated by sex hormone.