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生长激素对多囊卵巢综合征患者体外受精-胚胎移植的影响

Effects of growth hormone on in vitro fertilization-embryo transfer in patients with polycystic ovary syndrome

    摘要
  • 摘要:
    目的 探讨生长激素(GH)对多囊卵巢综合征(PCOS)患者体外受精-胚胎移植(IVF-ET)的影响。
    方法 选取110例PCOS患者作为研究对象, 采用随机数表法分为GH组与对照组，每组55例。2组患者均采用IVF-ET治疗，且GH组在促排卵过程中接受重组人生长激素(rhGH)肌肉注射治疗。比较2组患者治疗前与人绒毛膜促性腺激素(HCG)注射日(简称HCG日)的血清GH、胰岛素样生长因子-1(IGF-1)水平和取卵日的卵泡液GH、IGF-1水平，并比较2组患者卵母细胞发育情况和IVF-ET结局。
    结果 HCG日, GH组血清GH、IGF-1水平高于治疗前，差异有统计学意义(P < 0.05), 对照组血清GH、IGF-1水平与治疗前比较，差异无统计学意义(P>0.05)。HCG日, GH组血清GH、IGF-1水平依次为(9.76±2.32)、(146.54±23.79)μg/L, 分别高于对照组的(2.04±0.53)、(109.88±21.05)μg/L, 差异有统计学意义(P < 0.05); 取卵日, GH组卵泡液GH、IGF-1水平依次为(3.18±0.52)、(101.42±17.36)μg/L, 分别高于对照组的(2.66±0.48)、(89.17±13.58)μg/L, 差异有统计学意义(P < 0.05)。2组患者GV期、MⅠ期卵子数目比较，差异无统计学意义(P>0.05); GH组MⅡ期卵子数目为(15.16±3.23)个，多于对照组的(10.78±2.59)个，差异有统计学意义(P < 0.05)。GH组卵胞浆内单精子注射(ICSI)受精率、卵裂率、优质胚胎率依次为86.93%、93.66%、49.66%, 分别高于对照组的80.61%、88.91%、41.84%, 差异有统计学意义(P < 0.05)。
    结论 PCOS患者促排卵过程中外源性补充GH可提高血清和卵泡液中GH、IGF-1含量，促进卵母细胞发育，提高ICSI受精率和优质胚胎率。

     

    Abstract:
    Objective To investigate the effect of growth hormone (GH) on in vitro fertilization-embryo transfer (IVF-ET) in patients with polycystic ovary syndrome (PCOS).
    Methods A total of 110 PCOS patients were selected and divided into GH group and control group by random number table method, with 55 cases in each group. Both groups were treated with IVF-ET, and the GH group innovatively received intramuscular injection of recombinant human growth hormone(rhGH) during ovulation induction. The serum GH and insulin-like growth factor-1 (IGF-1) levels before treatment and on the injection day of human chorionic gonadotropin (HCG), levels of GH and IGF-1 in follicular fluid on the day of egg retrieval, development of oocytes, and IVF-ET outcomes of the two groups were compared.
    Results On HCG day, the serum GH, IGF-1 in the GH group were significantly increased than before treatment (P < 0.05), while the control group had no significant change compared with the treatment before (P>0.05). The serum GH, and serum IGF-1 on HCG day in the GH group were (9.76±2.32) μg/L and (146.54±23.79) μg/L, which were higher than (2.04±0.53) μg/L and (109.88±21.05) μg/L in the control group(P < 0.05); the follicular fluid GH and IGF-1 on the day of oocyte retrieval in the GH group were (3.18±0.52) μg/L and (101.42±17.36) μg/L, which were higher than (2.66±0.48) μg/L and (89.17±13.58) μg/L in control group, the differences were statistically significant (P < 0.05). There were no significant difference in the number of ovum in GV stage and MⅠstage between the two groups (P>0.05). The number ovum in M Ⅱ stage in the GH group was (15.16±3.23), which was higher than (10.78±2.59) in control group (P < 0.05). The fertilization rate, cleavage rate and high quality embryo rate of the GH group were 86.93%, 93.66% and 49.66%, which were higher than 80.61%, 88.91% and 41.84% in control group (P < 0.05).
    Conclusion The exogenous supplementation of GH in the process of ovulation induction in PCOS patients can increase the content of GH and IGF-1 in serum and follicular fluid, synergistically promote oocyte development and oocyte development, and increase ICSI fertilization rate and high-quality embryo rate.

     

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