卵泡液中血管内皮生长子和甾体激素水平对卵母细胞成熟和受精的影响

摘要

Objective: To investigate the roles of follicular fluid levels of vascular endothelial growth factor (VEGF) and steroid hormones in the maturation and fertilization of oocytes during controlled ovarian hyperstimulation (COH) cycles.Methods: Follicular fluids were obtained on the day of oocyte pickup from 105 follicles of 48 women undergoing intracytoplasmic sperm injection-embryo transfer (ICSI-ET) treatment. Follicular fluid levels of estradiol (E2), progesterone (P) and testosterone (T) were determined by electro-chemiluminescence immunoassay (ECLIA), and VEGF concentrations measured by enzyme-linked immunosorbent assay (ELISA). The effects of VEGF, E2, P and T in follicular fluids on human oocyte maturation and fertilization were analyzed.Results: Follicular fluid VEGF concentrations of mature oocytes were higher than those of immature oocytes (P＜0.05), but lower than those of postmature oocytes (P＜0.05). The highest maturation rate and fertilization rate were found in the oocytes with follicular fluid VEGF levels of 500-650 ng/L (P＜0.05). T levels in mature oocytes were significantly lower than those in immature oocytes (P＜0. 05).In degenerative oocytes, E2 levels were significantly lower than those in mature oocytes (P＜0.05). The maturation rate of oocytes with P/E2 ratios of 10-30 (91.11％) was higher than that of oocytes with P/E2 ＜l0 or ＞30 (P＜0. 05), while no significant difference in fertilization rate was found in these three groups of oocytes(P＞0. 05).Conclusions: The maturation and degeneration of oocytes were related to the intrafollicular steroid hormone levels on the day of oocyte pickup. The levels of VEGF in follicular fluids could reflect the oocyte maturation and fertilization.%目的 探讨卵胞浆内单精子注射(ICSI)周期取卵日卵泡液中血管内皮生长因子(VEGF)和甾体激素水平与卵母细胞成熟和受精的关系.方法 收集在本中心接受ICSI治疗的男方因素不育患者取卵日卵泡液105例,采用电化学发光法(ECLIA)检测卵泡液中雌二醇(E2)、孕酮(P)、睾酮(T)水平,酶联免疫吸附法(ELISA)检测VEGF水平.卵泡液按照相应卵母细胞成熟度及激素VEGF水平分别进行分组.结果 成熟组卵母细胞对应的卵泡液中VEGF水平高于未成熟组(P<0.05),而低于退化组(P<0.05);卵泡液VEGF水平在500～650 ng/L时卵母细胞成熟率、受精率最高(P<0.05);E2水平在退化组显著低于成熟组(P<0.05);P水平三组比较均无显著性差异(P>0.05);T水平在未成熟组和退化组均显著高于成熟组 (P<0.05);10≤P/E2≤30组卵子成熟率最高(91.11%)(P<0.05).结论 卵泡液中,VEGF水平在500～650 ng/L时卵母细胞成熟率、受精率较高.卵母细胞的成熟及退化与卵泡液中甾体激素环境关系密切,卵泡液P/E210～30范围时卵母细胞成熟率较高.