7日GnRHa短方案对卵泡液中IGF-II和IGFBP-4浓度的影响

目的：探讨7日促性腺激素释放激素激动剂(gonadotropin releasing hormone agonist,GnRHa)短方案与GnRHa长方案对卵泡液中胰岛素样生长因子-II（insulin-like growth factor II，IGF-II）和胰岛素样生长因子结合蛋白-4（insulin-like growth factor binding protein-4，IGFBP-4）浓度水平的影响。方法：将接受体外受精-胚胎移植（in vitro fertilization-embryo transfer，IVF-ET）治疗的88例输卵管因素不孕患者，随机分成7日GnRHa短方案组和GnRHa长方案组(n=44)。收集取卵日优势卵泡的卵泡液，采用放射免疫法测定IGF-II浓度，酶联免疫吸附法测定IGFBP-4浓度。结果：7日GnRHa短方案与长方案组相比较，Gn用量明显减少,用药时间明显缩短。两组间人绒毛膜促性腺激素(hCG)注射日血清雌二醇(E2)和每成熟卵泡E2的水平差异均无统计学意义(P＞0.05）。7日GnRHa短方案卵泡液的IGF-II和IGFBP-4水平明显低于GnRHa长方案组。两组间卵泡液的IGF-II/ IGFBP-4比值差异无统计学意义(P＞0.05）。卵泡液中的IGF-II水平与Gn 用量呈显著正相关。结论：7日GnRHa短方案与长方案引起卵泡液中IGF-II和IGFBP-4的浓度变化，但卵泡液中IGF-II和IGFBP-4浓度的改变并未导致临床结局的不同。

Effect of 7-day gonadotropin-releasing hormone agonist protocol on IGF-II and IGFBP-4 levels in the follicular fluid

ObjectiveTo explore the different effect of short 7-day gonadotropin releasing hormone agonist（GnRHa） protocol and GnRHa long protocol on the insulin-like growth factor Ⅱ（IGF-II）and insulin-like growth factor binding protein-4 （IGFBP-4）levels in follicular fluid. MethodsEighty-eight infertile patients due to tubal factors were included in this study. They were ramdonly divided into a short 7-day GnRHa protocol group and a GnRHa long protocol group (n=44). Follicular fluid was obtained from dominant follicles during oocyte retrieval. Levels of IGF-II and IGFBP-4 in the follicular fluid were detected by radioimmunoassay and enzyme-linked immunosorbent assay respectively.ResultsDuration of controlled ovarian stimulation was significantly shorter and the injected dosages of gonadotropin were significantly lower in the short 7-day protocol group. The differences in serum levels of estradiol and estradiol per mature follicle on the day of human chorionic gonadotropin injection between the two groups were not significant. The concentrations of IGF-II and IGFBP-4 in the follicular fluid of the short 7-day protocol group were significantly lower,while the difference of the ratio of IGF-II/IGFBP-4 between the two groups was not significant. Linear correlation analysis showed that IGF-II level in the follicular fluid was positively correlated to the total dose of gonadotropin.ConclusionThe short 7-day and long GnRHa protocols may affect the concentrations of IGF-II and IGFBP-4 in the follicular fluid. However, changes of IGF-II and IGFBP-4 concentrations do not contribute to different clinical outcomes.