[1]许菲菲,顾益惠,夏 飞.抑制素B在拮抗剂方案体外受精-胚胎移植中的变化及价值[J].医学信息,2022,35(07):79-83.[doi:10.3969/j.issn.1006-1959.2022.07.019]
　XU Fei-fei,GU Yi-hui,XIA Fei.Changes and Value of Inhibin B in Antagonist Protocol In Vitro Fertilization-embryo Transfer[J].Medical Information,2022,35(07):79-83.[doi:10.3969/j.issn.1006-1959.2022.07.019]
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抑制素B在拮抗剂方案体外受精-胚胎移植中的变化及价值()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年07期
页码:
79-83
栏目:
论著
出版日期:
2022-04-01

文章信息/Info

Title:
Changes and Value of Inhibin B in Antagonist Protocol In Vitro Fertilization-embryo Transfer
文章编号:
1006-1959（2022）07-0079-05
作者:
许菲菲; 顾益惠; 夏 飞
（1.泰州市人民医院妇产科，江苏 泰州 225300；2.苏州大学附属独墅湖医院妇产科，江苏 苏州 215000；3.苏州大学附属第一医院生殖中心，江苏 苏州 215000）
Author(s):
XU Fei-fei; GU Yi-hui; XIA Fei
(1.Department of Obstetrics and Gynecology,Jiangsu Taizhou People’s Hospital,Taizhou 225300,Jiangsu,China;2.Department of Obstetrics and Gynecology,Dushu LakeAffiliated to Soochow University,Suzhou 215000,Jiangsu,China;3.Reproductive Center,the First Af
关键词:
抑制素B; GnRH-A方案; 拮抗剂方案; 胚胎移植; 成熟卵泡数; 妊娠结局
Keywords:
Inhibin B; GnRH-a scheme; Antagonist programme; Embryo transfer; Number of mature follicles; Pregnancy outcome
分类号:
R321-33
DOI:
10.3969/j.issn.1006-1959.2022.07.019
文献标志码:
A
摘要:
目的 探讨血清抑制素B（INHB）在促性腺激素释放激素拮抗剂（GnRH-A）方案中的动态变化及对体外受精-胚胎移植（IVF-ET）结局预测价值。方法 回顾性分析2018年10月-2020年9月于苏州大学附属第一医院生殖中心首次接受GnRH-A方案的81例患者临床资料，收集月经第2或3天（Db）、Gn第5或6天（DGn）、使用GnRH-A 2 d后（DGnRH-A）、HCG日（DHCG）的血清INHB水平。将38例行新鲜周期胚胎移植的患者分为ET妊娠组（n=17）和ET未妊娠组（n=21）；将71例进行胚胎移植（新鲜周期和/或冷冻周期）的患者分为总妊娠组（n=40）和总未妊娠组（n=31）。10例患者未行胚胎移植，其中4例患者无可移植胚胎，6例患者在观察期内因个人原因未行胚胎移植。观察INHB的动态变化及与IVF-ET结局参数的相关性，比较各妊娠分组中血清INHB水平。结果 Db、DGn、DGnRH-A、DHCG的血清INHB水平呈现先上升后下降的趋势，INHB与Gn用量存在明显负相关（P＜0.05）；与大中卵泡数（直径≥14 mm）、成熟卵泡数（直径≥18 mm）、DHCG-E2、获卵数、2PN受精卵数、2PN卵裂数及胚胎数存在正相关（P＜0.05）；均与优质胚胎数无明确相关性。ET妊娠组中DGnRH-A-INHB水平低于ET未妊娠组，总妊娠组和总未妊娠组INHB水平比较，差异无统计学意义（P＞0.05）。结论 在GnRH-A方案促排卵过程中，血清INHB水平呈现先上升后下降的动态变化，血清INHB水平对卵巢功能、卵母细胞及胚胎数量存在一定的预测价值，其中加入GnRH-A后的血清INHB水平对新鲜周期胚胎移植妊娠结局可能存在预测价值。
Abstract:
Objective To investigate the dynamic changes of serum inhibin B (INHB) in gonadotropin releasing hormone antagonist (GnRH-A) protocol and its predictive value for in vitro fertilization-embryo transfer (IVF-ET) outcome.Methods The clinical data of 81 patients who received GnRH-A regimen for the first time in Reproductive Center of the First Affiliated Hospital of Soochow University from October 2018 to September 2020 were retrospectively analyzed. Serum INHB levels were collected on day 2 or 3 (Db), day 5 or 6 of menstruation (DGn), day 2 after GnRH-A (DGnRH-A) and day HCG (DHCG). Thirty-eight patients undergoing fresh embryo transfer were divided into ET pregnancy group (n=17) and ET non-pregnancy group (n=21). Seventy-one patients undergoing embryo transfer (fresh and/or frozen cycles ) were divided into total pregnancy group (n=40) and total non-pregnancy group (n=31). No embryo transfer was performed in 10 patients, including 4 patients without transferable embryos and 6 patients without embryo transfer due to personal reasons during the observation period. The dynamic changes of INHB and its correlation with IVF-ET outcome parameters were observed, and the serum INHB levels in each pregnancy group were compared.Results The serum INHB levels of Db, DGn, DGnRH-A and DHCG showed a trend of first increase and then decrease, and there was a significant negative correlation between INHB and Gn dosage (P<0.05), was positively correlated with the number of large and medium follicles (diameter≥14 mm), the number of mature follicles (diameter≥18 mm), DHCG-E2, the number of oocytes retrieved, the number of 2PN fertilized eggs, the number of 2PN cleavages and the number of embryos (P<0.05), there was no clear correlation between INHB and the number of high-quality embryos. The level of DGnRH-A-INHB in the ET pregnancy group was lower than that in the ET non-pregnancy group, and there was no significant difference in the INHB level between the total pregnancy group and the total non-pregnancy group (P>0.05).Conclusion During the course of COS with the GnRH-A protocol, the serum INHB level showed a dynamic change of rising first and then decreasing. The levels of serum INHB can predict ovarian function,the number of oocytes and embryos, and the level of serum INHB after adding GnRH-A may have predictive value on the pregnancy outcome of embryo transfer in fresh cycles.

参考文献/References:

[1]Demyashkin GA.Inhibin B in seminiferous tubules of human testes in normal spermatogenesis and in idiopathic infertility[J].Syst Biol Reprod Med,2019,65(1):20-28.[2]Andersen CY.Inhibin-B secretion and FSH isoform distribution may play an integral part of follicular selection in the natural menstrual cycle[J].Molecular Human Reproduction,2017,23(1):16.[3]张俊,周星宇,陈映雪,等.GnRH拮抗剂方案中西曲瑞克与加尼瑞克具有相似的抑制排卵效果和良好的妊娠结局[J].南方医科大学学报,2019,39(10):1207-1212.[4]Tencer J,Lemaire P,Brailly-Tabard S,et al.Serum inhibin B concentration as a predictor of age at first menstruation in girls with idiopathic central precocious puberty[J].PLoS One,2018,13(12):e0205810.[5]Robertson DM,Lee CH,Baerwald A.Interactions between serum FSH, inhibin B and antral follicle count in the decline of serum AMH during the menstrual cycle in late reproductive age[J].Endocrinol Diabetes Metab,2021,4(2):e00172.[6]张阿婷,刘芸.抑制素B参与卵泡优势化的机制[J].生殖医学杂志,2020,29(8):1105-1109.[7]Poulsen LC,Englund ALM,Andersen AS,et al.Follicular hormone dynamics during the midcycle surge of gonadotropins in women undergoing fertility treatment[J].Molecular Human Reproduction,2020,26(4):256-268.[8]中国女医师协会生殖医学专业委员会专家共识编写组.辅助生殖领域拮抗剂方案标准化应用专家共识[J].中华生殖与避孕杂志,2021,42(2):109-116.[9]杨琪,夏天,李爽,等.血清抑制素B对女性生殖功能的临床诊断价值[J].中国妇产科临床杂志,2016,17(2):187-189.[10]Jiao X,Meng T,Zhai Y,et al.Ovarian Reserve Markers in Premature Ovarian Insufficiency: Within Different Clinical Stages and Different Etiologies[J].Frontiers in Endocrinology,2021(12):601752.[11]Wang C,Li CJ,Li HJ,et al.Downregulation of the expression of inhibin α subunit and betaglycan in porcine cystic follicles[J].Vet Med Sci,2015,77(11):1419-1425.[12]Yetim Sahin A,Bas F,Yetim C,et al.Determination of insulin resistance and its relationship with hyperandrogenemia,anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome[J].Turkish Journal of Medical Sciences,2019,49(4):1117-1125.[13]Groome NP,Illingworth PJ,O’Brien M,et al.Measurement of dimeric inhibin B throughout the human menstrual cycle[J].The Journal of Clinical Endocrinology and Metabolism,1996,81(4):1401-1405.[14]刘小惠,吴小华.血清及卵泡液中抑制素B动态变化及其与促排卵结局的相关性研究[J].生殖与避孕,2016,36(11):897-903.[15]Khalifa E,Orief Y,Said T,et al.Fixed gonadotropin-releasing hormone antagonist protocol versus gonadotropin-releasing hormone agonist long protocol in patients with polycystic ovary syndrome treated for intracytoplasmic sperm injection cycles[J].International Journal of Reproduction, Contraception, Obstetrics and Gynecology,2016,5(4):1134-1139.[16]Danis RB,Sriprasert I,Ho J,et al.Bioavailable Inhibin B (Inhb) May BeaBetter Marker of Oocyte Yield Than Currently Used Markers of Ovarian Reserve[J].Fertility and Sterility,2020,114(3):e453.[17]Zhang F,Liu XL,Rong N,et al.Clinical Value of Serum Anti-Mullerian Hormone and Inhibin B in Prediction of Ovarian Response in Patients with Polycystic Ovary Syndrome[J].J Huazhong Univ Sci Technolog Med Sci,2017,37(1):70-73.[18]李莹,聂明月,方颖,等.多囊卵巢综合征患者控制性超促排卵过程AMH和INHB浓度变化的临床研究[J].首都医科大学学报,2014(4):402-406.[19]Pe?觡arrubia J,Peralta S,Fábregues F,et al.Day-5 inhibin B serum concentrations and antral follicle count as predictors of ovarian response and live birth in assisted reproduction cycles stimulated with gonadotropin after pituitary suppression[J].Fertility and Sterility,2010,94(7):2590-2595.[20]Yding Andersen C.Inhibin-B secretion and FSH isoform distribution may play an integral part of follicular selection in the natural menstrual cycle[J].Mol Hum Reprod,2017,23(1):16-24.[21]Wen J,Huang K,Du X,et al.Can Inhibin B Reflect Ovarian Reserve of Healthy Reproductive Age Women Effectively?[J].Front Endocrinol (Lausanne),2021(12):626534.[22]Fawzy M,Lambert A,Harrison RF,et al.Day5 inhibinB levels in a treatment cycle are predictive of IVF outcome[J].Hum Reprod,2002,17(6):1535-1543.[23]Danis RB,Sriprasert I,Ho JR,et al.Association of bioavailable inhibin B and oocyte yield in controlled ovarian stimulation[J].F S Rep,2021,2(2):189-194.[24]Pfister A,Crawford NM,Steiner AZ.Association between diminished ovarian reserve and luteal phase deficiency[J].Fertility and Sterility,2019,112(2):378-386.[25]常飞,吕爱霞,田飒,等.抗苗勒管激素联合抑制素B在高龄妇女卵巢储备功能评估中的应用价值[J].中国妇幼保健,2018,33(19):4474-4477.[26]Li Y,Nie M,Liu Y,et al.The dynamic changes of anti-Mullerian hormone and inhibin B during controlled ovarian hyperstimulation in decreased ovarian reserve women and the effect on clinical outcome[J]. Gynecological Endocrinology,2015,31(6):450-453.[27]季兆芳,朱晓艳,朱建华.PCOS不孕患者促排卵治疗期间血清AMH、INHB变化及与性激素的相关性研究[J].中国妇产科临床杂志,2021,22(1):86-87.[28]Turan T,Pekel A,Duvan ZCI,et al.Serum INHB Levels and ACE Gene I/D Polymorphism with Increased Risk for Unexplained Infertility[J].J Biochem,2021,170(2):245-253.

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更新日期/Last Update: 1900-01-01