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目的 探讨PCOS患者卵泡液中骨形成蛋白BMP6、BMP15、GDF9的异常改变与颗粒细胞凋亡的相关性及对IVF结局的影响.方法 将138例研究对象分为PCOS组与正常排卵组,对两组患者的临床及IVF批标进行对比分析,同时对两组患者的卵泡液行BMP6、BMP15、GDF9检测,且检测了两组颗粒细胞的Bcl-2及Caspase-3的表达情况,进而就卵液中的BMP6、BMP15、GDF9水平与颗粒细胞内的Bcl-2及Caspase-3表达量之间进行相关性分析.结果 PCOS组与对照组相比,患者的年龄、初潮年龄、Gn用量、获卵数、MⅡ卵率、受精率、优质胚胎率及临床妊娠率均无显著差别(P＞0.05),而BMI指数及可移植胚胎率均小于对照组,且差异具有统计学意义(P＜0.05).PCOS组与对照组相比,患者卵丘颗粒细胞内Bc1-2 mRNA及蛋白水平显著降低,而Caspase-3mRNA及蛋白水平升高,且差异具有统计学意义(P＜0.05).卵泡液中卵源性蛋白BMP6、BMP15与颗粒细胞内凋亡调控因子Bcl-2有呈正相关,与Caspase-3呈负相关性(P＜0.05).GDF9与Caspase-3呈负相关性(P＜0.05),与Bc1-2有一定相关性,但无统计学意义.结论 PCOS患者不仅卵泡液中存在BMP6、BMP15、GDF9的异常体变,且存在颗粒细胞内凋亡调控因子的异常改变,同时二者之间存在一定的相关性.“,”Objective:To investigate the potential effect of BMP6,BMP15 and GDF9 abnormal changes in follicular fluid on IVF outcome through the granulosa cell apoptosis.Methods:A total of 70 PCOS patients (PCOS group) and 68 female patients with normal ovarian function (control group) we collected.The general information,ages,retrieved cocyte number,BMI,Gn dosage,menarche age,fertilization rate,portable embryo rate,high-quality embryo rate,clinical pregnancy rate were recorded.Real-time PCR was used to detect the mRNA levels of Bc1-2 and Caspase-3 in the granulosa cell of all subjects.Western blotting was used to detect the expression of Bc1-2 and Caspase-3 in the granulosa cell and BMP6,BMP15 and GDF9 in the follicular fluid of all subjects.Results:Compared with control group,the BMI and portable embryo rate was significantly decreased (P＜0.05),the other general information have no significant differences (P＞0.05).The BMP6,BMP15 and GDF9 expression were significantly decreased in PCOS group compared with the control group (P＜0.05).The mRNA and protein levels of Bc1-2 were significantly increased and the Caspase-3 was significantly decreased in PCOS group compared with the control group (P＜0.05).The BMP6 and BMP15 were positively correlated with Bcl-2 (P＜0.05) and negatively correlated with Caspase-3 (P＜0.05).GDF9 was has negative correlation with Caspase-3 (P＜0.05) and has certain correlation with Bcl-2,but without statistical significance (P＞0.05).Conclusions:From these data above we supposed that the low expression of BMP6,BMP15 and GDF9 may affect oocyte quality and embryo development potential and be correlated with the granulosa cell apoptosis.