Relationship between sex hormone-binding globulin and pregnancy outcome in women undergoing controlled ovarian hyperstimulation for assisted reproduction
Relationship between sex hormone-binding globulin and pregnancy outcome in women undergoing controlled ovarian hyperstimulation for assisted reproduction
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DOI：
10.1507/endocrj.52.407
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发表时间：
2005-08-01
影响因子：
2
通讯作者：
Sun, MJ
中科院分区：
文献类型：
--
作者：
Lin, KC;Sun, MJ
本研究的目的是确定性激素结合球蛋白（SHBG）的变化是否会影响接受控制性卵巢过度刺激（COH）辅助生殖的女性的妊娠结局。 45 名不孕女性和 19 名月经周期正常的女性参与了这项研究，她们正在接受垂体脱敏和 COH 进行体外受精 (IVF)，有或没有胞浆内单精子注射 (ICSI)。获取卵泡期和黄体期的空腹血样，包括取卵期间的卵泡液，用于测定雌二醇 (E-2)、孕酮 (P)、睾酮 (T) 和 SHBG 浓度。 SHBG 水平在 COH 过程中逐渐增加，但在整个正常月经周期中保持恒定。卵泡期和黄体期E-2和SHBG水平均呈正相关。黄体期受孕女性的平均血浆 SHBG 浓度和 E-2/T 比值显着高于 COH 后未受孕的女性，而 T 水平和游离雄激素指数显着较低。卵泡液SHBG水平和E-2/T比值变化与血浆相似。因此，我们得出结论，卵泡期和黄体期 SHBG 的增加可能反映了卵巢刺激的功能状态，并且进一步认为，这种升高可能通过在 IVF/ICSI 下调的 COH 周期期间调节循环雌激素和雄激素平衡来影响妊娠结局。
The purpose of this study was to determine whether the changes of sex hormone-binding globulin (SHBG) affect the pregnancy outcome in women undergoing controlled ovarian hyperstimulation (COH) for assisted reproduction. Forty-five infertile women who were undergoing pituitary desensitization and COH for in vitro fertilization (IVF) with or without intracytoplasmic sperm injection (ICSI) and 19 women with normal menstrual cycles participated in the study. Fasting blood samples of the follicular and luteal phases, including follicular fluid during oocyte retrieval, were obtained for determination of estradiol (E-2), progesterone (P,), testosterone (T), and SHBG concentrations. The SHBG levels increased progressively during the course of COH, but remained constant throughout normal menstrual cycles. A positive correlation existed between E-2 and SHBG levels in both the follicular and luteal phases. The mean plasma SHBG concentration and E-2/T ratio were significantly higher, while the level of T and the free androgen index were significantly lower, in the luteal phase of women who conceived than in those who did not conceive following COH. The changes of follicular fluid SHBG level and E-2/T ratio were similar to those in plasma. We concluded, therefore, that increases in SHBG in the follicular and luteal phases may be a reflection of the functional state of ovarian stimulation, and further that such elevations may influence the pregnancy outcome through the modulation of circulating estrogen and androgen balance during down-regulated COH cycles for IVF/ICSI.