现代医学2024,Vol.52Issue(10) :1526-1534.DOI:10.3969/j.issn.1671-7562.2024.10.007

单纯性肥胖患者卵泡液中骨形态发生蛋白-15水平对胚胎质量的影响和初步预测价值

Effects of bone morphogenetic protein-15 levels in follicular fluid of patients with simple obesity on embryo quality and preliminary predictive value

王祁 梁慧
现代医学2024,Vol.52Issue(10) :1526-1534.DOI:10.3969/j.issn.1671-7562.2024.10.007

单纯性肥胖患者卵泡液中骨形态发生蛋白-15水平对胚胎质量的影响和初步预测价值

Effects of bone morphogenetic protein-15 levels in follicular fluid of patients with simple obesity on embryo quality and preliminary predictive value

王祁 1梁慧1
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作者信息

  • 1. 徐州市妇幼保健院,江苏 徐州 221000
  • 折叠

摘要

目的:探究单纯性肥胖患者取卵日卵泡液中骨形态发生蛋白-15(BMP-15)水平对体外受精/胞浆内单精子注射(IVF/ICSI)胚胎质量的影响和预测价值.方法:选取2022 年6 月至2023 年6 月于我院生殖医学中心行IVF/ICSI助孕的118 例不孕症患者为研究对象,按身体质量指数(BMI)分为对照组(18.5 kg·m-2≤BMI<24 kg·m-2)、超重组(24 kg·m-2≤BMI<28 kg·m-2)、肥胖组(BMI≥28 kg·m-2,)3 组.所有患者均采用拮抗剂方案促排卵,收集月经第3 天静脉血清,采用酶联免疫吸附试验法(ELISA)检测取卵日卵泡液中BMP-15 含量.结果:与对照组相比,肥胖组抗苗勒氏管激素(AMH)和基础黄体酮(bP)显著降低,肥胖组基础促卵泡生成素(bFSH)较对照组和超重组均降低,超重组bP较对照组明显降低(P<0.05).随着BMI增加,患者促性腺激素(Gn)用量显著增加,卵泡液BMP-15 水平显著降低(P<0.05).与对照组和超重组相比,肥胖组获卵总数、MetaphaseⅡ(MⅡ)率、囊胚形成率和优质胚胎率均减少(P<0.05).非肥胖患者BMP-15 高水平组受精率、优质胚胎率和囊胚形成率较低水平组均升高(P<0.05).肥胖患者BMP-15 高水平组MⅡ率、受精率、优质胚胎率和囊胚形成率较低水平组均升高(均P<0.05).肥胖患者卵泡液BMP-15 水平与MⅡ率、受精率、优质胚胎率和囊胚形成率均呈正相关.多因素逻辑回归分析显示BMP-15、AMH和bFSH是肥胖患者胚胎质量的独立影响因素(P<0.05).BMP-15、AMH和bFSH对肥胖患者胚胎质量结局均具有较好的预测价值,且BMP-15 联合bFSH组的检测效能明显高于单独检测(P<0.05).结论:肥胖会降低育龄期妇女的卵泡液BMP-15 表达,对胚胎质量产生负面影响,卵泡液BMP-15 联合血清bFSH检测对单纯性肥胖女性胚胎质量的预测有较好效能.

Abstract

Objective:To investigate the impact and predictive value of bone morphogenetic protein-15(BMP-15)levels in follicular fluid on the quality of embryos in patients with simple obesity undergoing in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI).Methods:A total of 118 infertile patients who underwent IVF/ICSI at the Reproductive Medicine Center of our hospital from June 2022 to June 2023 were enrolled.Based on body mass index(BMI),patients were divided into 3 groups:control group(18.5 kg·m-2≤BMI<24 kg·m-2),overweight group(24 kg·m-2≤BMI<28 kg·m-2),and obese group(BMI≥28 kg·m-2).All patients underwent ovarian stimulation using the antagonist protocol.Serum was collected on day 3 of menstruation,and BMP-15 levels in follicular fluid on the day of oocyte retrieval were measured using enzyme-linked immunosorbent assay(ELISA).Results:Compared to the control group,anti-Müllerian hormone(AMH)and baseline progesterone(bP)levels were significantly lower in the obese group,while baseline follicle-stimulating hormone(bFSH)levels were lower in both the obese and overweight groups(P<0.05).The amount of gonadotropins(Gn)required significantly increased with BMI,and BMP-15 levels in follicular fluid significantly decreased(P<0.05).The total number of retrieved oocytes,Metaphase Ⅱ(MⅡ)rate,blastocyst formation rate,and high-quality embryo rate were all lower in the obese group compared to the control and overweight groups(P<0.05).In non-obese patients,the high BMP-15 group had higher fertilization,high-quality embryo,and blastocyst formation rates compared to the low BMP-15 group(P<0.05).Among obese patients,the high BMP-15 group had higher MⅡ,fertilization,high-quality embryo,and blastocyst formation rates than the low BMP-15 group(all P<0.05).In obese patients,BMP-15 levels in follicular fluid were positively correlated with MⅡ rate,fertilization rate,high-quality embryo rate,and blastocyst formation rate.Multivariate Logistic regression analysis showed that BMP-15,AMH,and bFSH were independent influencing factors for embryo quality in obese patients(P<0.05).The combined detection of BMP-15 and bFSH demonstrated better predictive performance for embryo quality outcomes than individual detection(P<0.05).Conclusion:Obesity reduces BMP-15 expression in follicular fluid of women of reproductive age,negatively affecting embryo quality.The combined detection of follicular fluid BMP-15 and serum bFSH has reliable predictive value for embryo quality in women with simple obesity.

关键词

骨形态发生蛋白-15/身体质量指数/卵泡液/体外受精/胞浆内单精子注射/胚胎质量

Key words

bone morphogenetic protein-15/body mass index/follicular fluid/in vitro fertilization/intracytoplasmic sperm injection/quality of embryos

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出版年

2024
现代医学
东南大学

现代医学

CSTPCD
影响因子:0.703
ISSN:1671-7562
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