Effect of Endometrioma cystectomy on cytokines of follicular fluid and IVF outcomes
Effect of Endometrioma cystectomy on cytokines of follicular fluid and IVF outcomes
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子宫内膜异位囊肿切除术对卵泡液细胞因子及IVF结局的影响
DOI：
10.1186/s13048-019-0572-7
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发表时间：
2019-10-21
影响因子：
4
通讯作者：
Wang, Shuyu
中科院分区：
文献类型：
--
作者：
Liang, Yu;Yang, Xiaokui;Wang, Shuyu
背景子宫内膜异位症患者接受体外受精-胚胎移植（IVF-ET）治疗的成功率较低。IVF-ET的成功与子宫的容受性和胚胎的质量有关，众所周知，患者的子宫内膜异位症不会损害容受性。在IVF之前是否应该手术切除子宫肌瘤仍然存在争议。研究表明，卵巢囊肿切除术可减少腹膜炎症，但有关卵泡液中细胞因子变化的信息很少。本研究的目的是探讨子宫内膜异位症膀胱切除术对IVF结局和滤泡内炎症细胞因子水平的影响，并探讨细胞因子浓度与IVF结局之间的相关性。方法共招募了41名接受IVF的子宫内膜异位症相关不孕症女性; 13例患者（手术组，S组）在入组前接受了手术切除子宫肌瘤，28例患者（非手术组，NS组）在IVF前未经治疗。卵泡液从一个占优势的卵泡收集在卵母细胞检索过程中，和已知参与卵巢function. ResultsAmong可溶性分子的浓度进行了测量，在这项研究中，趋化因子和生长因子和一些炎症细胞因子被发现在子宫内膜异位症患者的卵泡液。此外，S组和NS组的趋化因子、生长因子和大多数炎性细胞因子的表达水平没有差异，但NS组的白细胞介素（IL）-18水平显著降低。然而，FF中的IL-18水平与IVF周期参数无关。植入和临床妊娠率两组之间是相似的，但抗苗勒管激素（AMH）水平低于S组比在NS group.ConclusionsThese研究结果表明，卵巢癌手术可能会降低卵巢储备和IVF的成功率影响不大。卵巢腺瘤与不孕妇女FF中的细胞因子谱无关，并且它们不太可能由于炎症机制而影响卵母细胞和胚胎的质量。
BackgroundEndometriosis patients undergoing in vitro fertilization-embryo transfer (IVF-ET) treatment suffer from lower success rates. The success of IVF-ET is related to the receptivity of the uterus and the quality of embryos, and it is well known a patient’s endometriosis does not impair the receptivity. Whether endometrioma should be removed surgically before IVF remains controversial. Studies have shown that endometrioma removal decreases peritoneal inflammation, but little information is available regarding the alteration in the cytokines of follicular fluid. The objective of this study was to examine the impact of endometrioma cystectomy on the outcome of IVF and the levels of intrafollicular inflammatory cytokines and to investigate correlations between cytokine concentrations and IVF outcomes.MethodA total of 41 women with endometriosis-associated infertility undergoing IVF were recruited; 13 patients (surgery group, S group) had surgery to remove the endometrioma before enrollment, and 28 patients (non-surgery group, NS group) were untreated before IVF. The follicular fluid from a dominant follicle was collected during oocyte retrieval, and the concentrations of sixteen soluble cytokines known to be involved in ovarian function were measured.ResultsAmong the soluble molecules examined in this study, chemokines and growth factors and a few are inflammatory cytokines were found in the follicular fluid of patients with endometriosis. In addition, the expression levels of chemokines, growth factors, and most inflammatory cytokines did not differ between the S and NS groups, but interleukin (IL)-18 levels were significantly lower in the NS group. However, the levels of IL-18 in the FF did not correlate with IVF cycle parameters. The implantation and clinical pregnancy rates were similar between the two groups, but the anti-Müllerian hormone (AMH) level was lower in the S group than in the NS group.ConclusionsThese findings suggest that endometrioma surgery may potentially reduce the ovarian reserve and has little impact on the success rate of IVF. Ovarian endometriomas are not associated with cytokine profiles in FF from infertile women, and they are not likely to affect the quality of the oocyte and embryo as a result of an inflammatory mechanism.