同型半胱氨酸对多囊卵巢综合征患者卵子质量及发育潜能的影响

目的:探讨同型半胱氨酸对行体外受精-胚胎移植(IVF-ET)治疗的多囊卵巢综合征(PCOS)患者卵子质量和发育潜能的影响。方法:选择首次行IVF-ET治疗的PCOS患者9例(PCOS组)及输卵管因素不孕患者13例(对照组),比较两组患者取卵日空腹血浆及卵泡液总同型半胱氨酸(tHcy)浓度以及卵子发育情况。结果:PCOS患者取卵日血浆及卵泡液tHcy浓度均较对照组显著升高(均P<0·01);PCOS患者卵子回收率、成熟率、受精率、卵裂率、优质胚胎率均显著低于对照组(均P<0·05);卵泡液tHcy浓度与受精率、卵裂率、优质胚胎率负相关(均P<0·01);卵泡液tHcy浓度与血浆tHcy浓度正相关(P<0·0001)。结论:PCOS患者血浆及卵泡液总同型半胱氨酸浓度显著升高;血浆及卵泡液高浓度同型半胱氨酸是影响PCOS患者卵子质量、发育潜能及妊娠结局的一个重要因素。

Effects of homocysteine on the quality and developmental potential of the ooeytes in patients with pilycystic ovary syndrome

Objective:To investigate the effect of homocysteine on the quality and developmental potential of the human oocytes in patients with polycystic ovary syndrome undergoing in vitro fertilization-embryo transfer(IVF-EF).Methods:Nine infertile patients with PCOS(PCOS group) and thirteen patients with tube infertility(control group) who underwent IVF-EF cycles at first time were involved.The homocysteine concentrations both in the plasma and follicular fluid in the day of oocyle retrieval were measured.Meanwhile,the quality of oocytes and the outcomes of insemination and subsequent embryo development were also recorded.Results:Homocysteine concentration in the plasma and follicular fluid in patients with PCOS was significantly higher than that in the contorl group(all P<0.01).Oocyte retrieval rate,maturation rate,fertilization rate,cleavage rate and high-quality embryo rate in PCOS group were dramaticaly lower than those in control group.The level of homocysteine in the follicular fluid correlated negtively with fertilization rate,cleavage rate,cleavage rate and high-quality embryo rate respectively(all P<0.01).Homocysteine in the follicular fluid correlated positively with that in the plasma(P<0.01).Conclusion:In patients with PCOS,homocysteine concentration in the plasma and follicular fluid is increased and is probably related to the quality of oocytes,the developmental competence and subsequent pregnancy outcomes.