血清25-OH-VD、Hcy和免疫细胞水平与卵巢反应性的研究
|
摘要
目的探讨卵巢反应性与25-羟基维生素D(25-OH-VD)、同型半胱氨酸(Hcy)及免疫细胞亚群(T细胞、B细胞、NK细胞)之间的关系。方法选取接受体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)治疗的179例患者作为观察对象,根据获卵数目分为卵巢低反应组和正常反应组,比较两组的25-OH-VD、Hcy、T细胞、B细胞、NK细胞表达情况。结果两组患者降调后的促卵泡生长激素(FSH)、黄体生成素(LH)、雌二醇(E2)、子宫内膜厚度、窦卵泡直径比较,差异无统计学意义(P>0.05);卵巢低反应组中Hcy水平均高于正常反应组,差异有统计学意义(P<0.05),但两组的促排天数、促排用量、25-OH-VD水平比较,差异无统计学意义(P>0.05);卵巢低反应组中T细胞、Th细胞水平均稍高于正常反应组,差异无统计学意义(P>0.05),但NK细胞比例显著高于正常反应组,差异有统计学意义(P<0.05)。结论 Hcy与NK细胞比例升高可能与卵巢低反应存在密切的相关性,可能会危害女性的生殖健康,应引起临床重视。
Objective To investigate the relationship between ovarian responsiveness and 25-OH-VD, homocysteine(Hcy) and immune cell subsets(T cells, B cells, NK cells).Methods 179 patients who received in vitro fertilization or intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET) treatment were divided into ovarian hyporesponsiveness group and normal responsiveness group according to the number of eggs. The expression of 25-OH-VD, Hcy, T cells, B cells and NK cells in the two groups were compared.Results There was no significant difference in follicle-stimulating hormon(FSH), luteinizing hormone(LH), estradiol(E2), endometrial thickness and sinus follicle diameter between the two groups(P>0.05). The level of Hcy in the ovarian hyporesponsiveness group was higher than that in the normal responsiveness group(P<0.05), but there was no significant difference in the days and the dose of ovarian hyperstimulation, the level of 25-OH-VD between the two groups. The levels of T cells and Th cells in ovarian hyporesponsiveness group were slightly higher than those in normal responsiveness group(P>0.05), but the proportion of NK cells in ovarian hyporesponsiveness group was significantly higher than that in normal responsiveness group(P<0.05).Conclusion The increase of the ratio of Hcy and NK cells may be closely related to ovarian hyporesponsiveness, which may endanger the reproductive health of women and should be paid more attention in clinic.
Objective To investigate the relationship between ovarian responsiveness and 25-OH-VD, homocysteine(Hcy) and immune cell subsets(T cells, B cells, NK cells).Methods 179 patients who received in vitro fertilization or intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET) treatment were divided into ovarian hyporesponsiveness group and normal responsiveness group according to the number of eggs. The expression of 25-OH-VD, Hcy, T cells, B cells and NK cells in the two groups were compared.Results There was no significant difference in follicle-stimulating hormon(FSH), luteinizing hormone(LH), estradiol(E2), endometrial thickness and sinus follicle diameter between the two groups(P>0.05). The level of Hcy in the ovarian hyporesponsiveness group was higher than that in the normal responsiveness group(P<0.05), but there was no significant difference in the days and the dose of ovarian hyperstimulation, the level of 25-OH-VD between the two groups. The levels of T cells and Th cells in ovarian hyporesponsiveness group were slightly higher than those in normal responsiveness group(P>0.05), but the proportion of NK cells in ovarian hyporesponsiveness group was significantly higher than that in normal responsiveness group(P<0.05).Conclusion The increase of the ratio of Hcy and NK cells may be closely related to ovarian hyporesponsiveness, which may endanger the reproductive health of women and should be paid more attention in clinic.
引文
[1] Broekmans F J,Kwee J,Hendriks D J,et al.A systematic review of tests predicting ovarian reserve and IVF outcome[J].Hum Reprod,2006,12(6):685-718.
[2] Ferraretti A P,La Marca A,Fauser B C,et al.ESHRE consensus on the definition of 'poor response' to ovarian stimulation for in vitro fertilization:the Bologna criteria[J].Hum Reprod,2011,26(7):1616-24.
[3] 李丽娟,孟昱时,范文,等.尿卵泡刺激素、黄体生成素全定量测定在促性腺激素释放激素激动剂降调节后的应用价值[J].生殖医学杂志,2014,23(1):33-6.
[4] Blomberg J M.Vitamin D and male reproduction[J].Nat Rev Endocrind,2014,10(3):175-86.
[5] Merhi Z,Doswel A D,Krebs K,et al.Vitamin D alters genes involved in folicular development and steroidogenesis in human cumulus granulosa cels[J].J Clin Endocrinol Metab,2014,99(6):E1137-45.
[6] Irani M,Merhi Z.Role of vitamin D in ovarian physiology and its implication in reproduction:a systematic review[J].Fertil Steril,2014,102(2):460-8.
[7] Rudick B,Ingles S,Chung K,et al.Characterizing the influence of vitamin D levels on IVF outcomes[J].Hum Reprod,2012,27(11):3321-7.
[8] Boxmeer J C,Smit M,Utomo E,et al.Low folate in seminal plasma is associated with increased sperm DNA damage[J].Fertil Steril,2009,92 (2):548-56.
[9] Market Velker B A,Denomme M M,Mann M R.Loss of genomic imprinting in mouse embryos with fast rates of preimplantation development in culture[J].Biol Reprod,2012,86(5):1-16.
[10] Safdarian L,Najmi Z,Aleyasin A,et al.Recurrent IVF failure and hereditary thrombophilia[J].Iran J Reprod Med,2014,12(7):467-70.
[11] Almasry S M,Elmansy R A,Elfayomy A K,et al.Ultrastructure alteration of decidual natural killer cells in women with unexplained recurrent miscarriage:a possible association with impaired decidual vascular remodelling[J].J Mol Histol,2015,46(1):67-78.
[12] Ratsep M T,Felker A M,Kay V R,et al.Uterine natural killer cells:supervisors of vasculature construction in early decidua basalis[J].Reproduction,2015,149(2):R91-102.
[13] Jimmy E J,Moshe B,Sami H,et al.Prospective evaluation of early follicular ovarian stromal blood flow in infertile women undergoing IVF-ET treatment[J].Informa,2012,28(5):356-9.
[14] Karami N,Boroujerdnia M G,Nikbakht R,et al.Enhancement of peripheral blood CD56(dim) cell and NK cell cytotoxicity in women with recurrent spontaneous abortion or in vitro fertilization failure[J].J Reprod Immunol,2012,95(1/2):87-92.
[2] Ferraretti A P,La Marca A,Fauser B C,et al.ESHRE consensus on the definition of 'poor response' to ovarian stimulation for in vitro fertilization:the Bologna criteria[J].Hum Reprod,2011,26(7):1616-24.
[3] 李丽娟,孟昱时,范文,等.尿卵泡刺激素、黄体生成素全定量测定在促性腺激素释放激素激动剂降调节后的应用价值[J].生殖医学杂志,2014,23(1):33-6.
[4] Blomberg J M.Vitamin D and male reproduction[J].Nat Rev Endocrind,2014,10(3):175-86.
[5] Merhi Z,Doswel A D,Krebs K,et al.Vitamin D alters genes involved in folicular development and steroidogenesis in human cumulus granulosa cels[J].J Clin Endocrinol Metab,2014,99(6):E1137-45.
[6] Irani M,Merhi Z.Role of vitamin D in ovarian physiology and its implication in reproduction:a systematic review[J].Fertil Steril,2014,102(2):460-8.
[7] Rudick B,Ingles S,Chung K,et al.Characterizing the influence of vitamin D levels on IVF outcomes[J].Hum Reprod,2012,27(11):3321-7.
[8] Boxmeer J C,Smit M,Utomo E,et al.Low folate in seminal plasma is associated with increased sperm DNA damage[J].Fertil Steril,2009,92 (2):548-56.
[9] Market Velker B A,Denomme M M,Mann M R.Loss of genomic imprinting in mouse embryos with fast rates of preimplantation development in culture[J].Biol Reprod,2012,86(5):1-16.
[10] Safdarian L,Najmi Z,Aleyasin A,et al.Recurrent IVF failure and hereditary thrombophilia[J].Iran J Reprod Med,2014,12(7):467-70.
[11] Almasry S M,Elmansy R A,Elfayomy A K,et al.Ultrastructure alteration of decidual natural killer cells in women with unexplained recurrent miscarriage:a possible association with impaired decidual vascular remodelling[J].J Mol Histol,2015,46(1):67-78.
[12] Ratsep M T,Felker A M,Kay V R,et al.Uterine natural killer cells:supervisors of vasculature construction in early decidua basalis[J].Reproduction,2015,149(2):R91-102.
[13] Jimmy E J,Moshe B,Sami H,et al.Prospective evaluation of early follicular ovarian stromal blood flow in infertile women undergoing IVF-ET treatment[J].Informa,2012,28(5):356-9.
[14] Karami N,Boroujerdnia M G,Nikbakht R,et al.Enhancement of peripheral blood CD56(dim) cell and NK cell cytotoxicity in women with recurrent spontaneous abortion or in vitro fertilization failure[J].J Reprod Immunol,2012,95(1/2):87-92.