促性腺激素释放激素激动剂扳机对卵巢过度刺激综合征高风险患者临床结局影响及其相关机制研究

发布时间：2018-10-07 19:24

【摘要】：目的评估促性腺激素释放激素激动剂(Gn RH-a)扳机对卵巢过度刺激综合征(OHSS)高风险患者临床结局的影响及其相关机制。方法回顾性分析2015年1-12月广州医科大学附属第三医院生殖医学中心96例OHSS高风险患者,其中Gn RH-a单扳机(48例)和重组人绒毛膜促性腺激素(r-HCG)扳机(48例)应用于患者的体外受精(IVF)周期,并对其中28例患者的颗粒细胞卵丘扩展基因肿瘤坏死因子诱导基因6蛋白(TNFAIP6)和透明质酸合成酶2(HAS2)的表达水平进行分析。结果两组患者年龄、不孕因素、基础内分泌情况、扳机日雌二醇水平、16 mm卵泡数、获卵数、卵裂率、优胚率差异均无统计学意义。与r-HCG扳机相比,Gn RH-a单扳机方案可将OHSS发生率降至0,且能获得更高的受精率(90.22%vs.85.97%,P=0.003)和卵子利用率(44.48%vs.39.34%,P=0.020)。Gn RH-a扳机使颗粒细胞TNFAIP6和HAS2 m RNA的表达明显增高(1.40±0.16 vs.1.00±0.12,P=0.043;1.69±0.23 vs.1.00±0.20,P=0.030)。结论 Gn RH-a扳机方案应用在高反应人群安全有效。Gn RH-a扳机方案中更高的受精率和卵子利用率可能与颗粒细胞上TNFAIP6和HAS2 m RNA的表达增高有关。
[Abstract]:Objective to evaluate the effect of gonadotropin releasing hormone agonist (Gn RH-a) trigger on the clinical outcome of patients with ovarian hyperstimulation syndrome (OHSS) at high risk. Methods 96 patients with high risk of OHSS in the Center of Reproductive Medicine, third affiliated Hospital of Guangzhou Medical University from January to December 2015 were retrospectively analyzed. Gn RH-a single trigger (48 cases) and recombinant human chorionic gonadotropin (r-HCG) trigger (48 cases) were used in IVF (IVF) cycle. The expression levels of tumor necrosis factor-inducible gene 6 (TNFAIP6) and hyaluronic acid synthase 2 (HAS2) were analyzed in 28 patients with granulosa cell cumulus expansion gene. Results there were no significant differences between the two groups in age, infertility factors, basal endocrine condition, the number of follicles at the level of estradiol (16 mm), the number of oocytes acquired, the rate of cleavage, and the rate of superior embryo. Compared with r-HCG trigger, Gn RH-a single trigger could reduce the incidence of OHSS to 0, and obtain higher fertilization rate (90.22vs.85.97v 路P0. 003) and egg utilization ratio (44.48vs.39.34G) .Gn RH-a trigger could significantly increase the expression of TNFAIP6 and HAS2 m RNA in granulosa cells (1.40 卤0.16 vs.1.00 卤0.12P 0.043 卤0.23 vs.1.00 卤0.20P 0.030). Conclusion the higher fertilization rate and egg utilization rate of Gn RH-a trigger regimen in the safe and effective. Gn RH-a trigger regimen may be related to the increased expression of TNFAIP6 and HAS2 m RNA in granulosa cells.
【作者单位】：广州医科大学附属第三医院生殖医学中心;广东省生殖重点实验室;广东省生殖与遗传重点实验室;
【基金】：广东省教育厅科研项目(2014KZDXM047)
【分类号】：R714.8

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