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目的:探讨IVF-ET/ICSI患者中FSH受体(FSHR)基因多态性对控制促排卵中卵巢反应性及妊娠结局的影响。方法:分析行IVF-ET/ICSI的223例患者资料,其中长方案174例,短方案37例,微刺激方案12例。通过PCR扩增、纯化、基因测序分别测得223例患者FSHR体基因在外显子10上第680位及307位的基因型,根据不同基因型分为Asn680/Asn680、Ser680/Ser680、Asn680/Ser680;Thr307/Thr307、Ala307/Ala307、Ala307/Thr307各3组。比较223例患者不孕因素在各组的分布;比较174例长方案促排卵患者不同FSHR基因型亚组的卵巢反应及妊娠结局。结果:223例患者中,FSHR基因680位点上Asn/Asn组占52.0%,Ser/Ser组占12.1%,Asn/Ser组占35.9%,307位点上Ala/Ala组占12.1%,Thr/Thr组占48.4%,Ala/Thr组占39.5%。174例长方案患者中Ser680/Ser680组及Ala307/Ala307亚组的基础FSH值显著高于其它2个基因型组(P<0.05);FSH受体基因680、307位点多态性的改变在OHSS发生上无预测作用(P>0.05),但OHSS发生组中SS680的分布频率(4.6%)明显低于非OHSS组(15.1%)。FSHR基因680、307位点多态性的改变与临床妊娠率无相关性。结论:FSHR基因680、307位多态性的分布存在差异,FSHR基因多态性Ser680和AA307可能与卵巢反应性有关,FSHR基因680、307位多态性与临床妊娠率无关。
Objective: To investigate the effect of FSH receptor (FSHR) gene polymorphism on ovarian response and pregnancy outcomes in ovulation induction in patients with IVF-ET / ICSI. Methods: The data of 223 patients who underwent IVF-ET / ICSI were analyzed. Among them, 174 were long and 37 were short and 12 were micro-stimulation. The genotypes of the 680th and 307th loci of FSHR gene in exon 10 of 223 patients were determined by PCR amplification, purification and gene sequencing. The genotypes were divided into Asn680 / Asn680, Ser680 / Ser680, Asn680 / Ser680 ; Thr307 / Thr307, Ala307 / Ala307, Ala307 / Thr307 each 3 groups. The distribution of infertility in each group was compared among 223 cases. The ovarian response and pregnancy outcome in 174 subtypes with different FSHR genotypes in patients with long-term ovulation induction were compared. Results: Among 223 patients, Asn / Asn was found in 680 loci of FSHR gene in 52.0%, Ser / Ser in 12.1%, Asn / Ser in 35.9%, Ala / Ala in 307 locus accounted for 12.1%, Thr / Thr group accounted for 48.4%, Ala / Thr group accounted for 39.5%. The basal FSH values of Ser680 / Ser680 and Ala307 / Ala307 subtypes in 174 patients with long-term regimen were significantly higher than those of the other 2 genotypes (P <0.05). The polymorphisms of 680 and 307 of FSH receptor gene were (P> 0.05). However, the distribution frequency of SS680 in OHSS group (4.6%) was significantly lower than that in non-OHSS group (15.1%). There was no correlation between FSHR gene 680,307 polymorphism and clinical pregnancy rate. CONCLUSIONS: The polymorphisms of 680 and 307 polymorphisms in FSHR gene are different. Ser680 and AA307 in FSHR gene may be related to ovarian reactivity. The 680 and 307 polymorphisms in FSHR gene have no relation with clinical pregnancy rate.