生长激素对卵巢储备功能减低患者卵泡发育的影响

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[目的]探讨重组人生长激素(Growth Hormone,GH)对体外受精-胚胎移植(IVF-ET)治疗中的卵巢储备功能减低(Decreased Ovarian Reserve,DOR)患者卵泡发育的影响.[方法]收集接受IVF-ET治疗的DOR患者20例,根据患者意愿分为观察组(11例,使用GH)和对照组(9例,未用GH).于取卵日收集两组患者单个优势卵泡(直径≥16 mm)的卵泡液,应用Western Blot方法半定量检测每个卵泡的胰岛素样生长因子-1(IGF-1)、IGF-1受体(IGF-1R)、GH水平,评估其与卵子质量、胚胎质量、妊娠结局的相关性.[结果]两组促性腺激素(Gn)总量、Gn用药天数、优胚率、周期取消率比较差异无统计学意义(P>0.05);观察组取卵日优势卵泡数、获卵数与MII卵子数明显高于对照组(P<0.05);GH组临床妊娠率25%,对照组无临床妊娠.两组卵泡液GH水平与IGF-1、IGF-1R水平成正相关(R=0.55与0.58).观察组卵泡液GH水平显著高于对照组(P<0.05),而IGF-1、IGF-1R水平比较差异无统计学意义(P>0.05).MII卵泡液IGF-1R、GH水平均高于同组无MII卵泡(P<0.05),高于对照组MⅡ卵泡(P<0.05);GH组无MⅡ卵泡液IGF-1、IGF-1R、GH水平与对照组MII卵泡比较差异无统计学意义(P>0.05),但高于对照组无MII卵泡液水平.[结论]对IVF治疗中的DOR患者添加GH,有利于提高患者卵泡液中IGF1与IGF1R水平,有利于卵泡成熟及提高卵子质量.“,”[Objective]To explore the effects of growth hormone(GH)on follicular development in patients with decreased ovarian reserve(DOR)under in-vitro fertilization-embryo transfer (IVF-ET).[Methods]A total of 20 DOR patients received IVF-ET therapy were divided into observation group (11 cases,GH) and control group (9 cases,without GH) according to the wishes of patients.On the day of oocyte retrieval,follicular fluid of single dominant follicle (diameter ≥16 mm) of the two groups was collected,and by Western Blot method,semi quantitative detection of each follicle insulin-like growth factor-1 (IGF-1),IGF-1 receptor (IGF-1R) and GH were conducted;and their correlation with egg quality,embryo quality and the outcome of pregnancy were assessed.[Results] Total Gonadotropin (Gn),Gn duration,good embryo rate and cycle cancellation rate of the two groups had no significant difference (P >0.05);the number of dominant follicles on the day of oocyte retrieval,the number of oocytes obtained and MII oocytes of the observation group were significantly higher than those of the control group (P <0.05);The clinical pregnancy rate of the GH group was 25%,while the control group had no clinical pregnancy.GH level of follicular fluid of the two groups was positively correlated with that of IGF-1 and IGF-1R (R=0.55 and 0.58).GH levels of follicular fluid in the observation group were significantly higher than those in the control group (P <0.05);comparing with the level of IGF-1 and IGF-1R,the difference was not statistically significant (P >0.05).IGF-1R and GH levels with MII follicular fluid were higher than those without MII follicular fluid in the same group (P <0.05),and were higher than that of the control group with MII follicular fluid (P <0.05);comparison of IGF-1,IGF-1R without MII follicular fluid in the GH group with those in control group with follicle showed no significant difference (P >0.05),but higher than that of the control group without MII follicular fluid.[Conclusion] GH addition to DOR patients underwent IVF therapy could increase the level of IGF-1,IGF-1R in follicular fluid,and is conducive to improving follicle maturation and follicle qualities.
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