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目的:通过检测行体外受精胚胎移植治疗周期的不育症患者在不同阶段血清及卵泡液内血管内皮生长因子(VEGF)和胰岛素样生长因子-Ⅱ(IGF-Ⅱ)的浓度变化,探讨血管内皮生长因子和胰岛素样生长因子-Ⅱ的浓度与体外受精胚胎移植妊娠结局的关系。方法:行体外受精胚胎移植的妇女45例,在取卵日分别抽取外周血,穿刺取卵时留取卵泡液,应用酶联免疫法及放射免疫法测定血管内皮生长因子和胰岛素样生长因子-Ⅱ的浓度变化并记录体外受精-胚胎移植妊娠结局。结果:血清IGF-Ⅱ水平高于卵泡液,二者比较,差异有统计学意义(P<0.01),卵泡液中VEGF水平明显高于血清,差异有统计学意义。妊娠组与未妊娠组血清及卵泡液IGF-Ⅱ、VEGF水平分别比较,差异均有统计学意义(P<0.05)。结论:血管内皮生长因子(VEGF)是诱导卵泡生长发育的重要细胞因子,它通过旁分泌或自分泌调节卵母细胞的成熟,并直接影响早期胚胎的质量,从而影响IVF-ET的结局。IGF-Ⅱ是卵巢中具有重要生物学效应的调节因子,在卵巢局部可能以自分泌和(或)旁分泌的方式调节卵巢功能。患者血清及卵泡液中胰岛素样生长因子-Ⅱ(IGF-Ⅱ)水平有高于非妊娠患者的倾向。
OBJECTIVE: To investigate the changes of the concentrations of vascular endothelial growth factor (VEGF) and insulin-like growth factor-Ⅱ (IGF-Ⅱ) in serum and follicular fluid of infertile patients who underwent IVF embryos transfer cycle. The Relationship Between Growth Factors, Insulin - like Growth Factor - Ⅱ Concentration and Pregnancy Outcome after In Vitro Fertilization Embryo Transfer. Methods: Forty - five women underwent in vitro fertilization embryo transfer. Peripheral blood was collected on the day of ovulation, and follicular fluid was collected during the time of ovulation. Enzyme - linked immunosorbent assay and radioimmunoassay were used to detect the expression of vascular endothelial growth factor and insulin - like growth factor - Ⅱ concentration changes and record in vitro fertilization - embryo transfer pregnancy outcome. Results: The level of serum IGF-Ⅱ was higher than that of follicular fluid. The difference was statistically significant (P <0.01). The level of VEGF in follicular fluid was significantly higher than that in serum. The difference was statistically significant. The levels of IGF-Ⅱ and VEGF in serum and follicular fluid between pregnancy group and non-pregnant group were significantly different (P <0.05). Conclusion: Vascular endothelial growth factor (VEGF) is an important cytokine that induces follicle growth and development. It regulates the maturation of oocytes by paracrine or autocrine and directly affects the quality of early embryos, thus affecting the outcome of IVF-ET. IGF-II is a regulator of ovarian important biological effects, ovarian function may be regulated in the ovary in an autocrine and / or paracrine manner. Patients with serum and follicular fluid insulin-like growth factor-Ⅱ (IGF-Ⅱ) levels are higher than in non-pregnant patients tend to.