不孕症妇女血清中稀土元素与体外受精-胚胎移植结局的关联性研究

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摘要目的探讨行体外受精-胚胎移植(IVF-ET)妇女血清中稀土元素含量与IVF-ET结局的关联性。方法本研究于2016年10月至2017年5月在北京大学人民医院采用前瞻性巢式病例对照研究的方法共募集84名患有不孕症并且实施IVF-ET的妇女。通过问卷调查研究对象社会人口学信息,从病历记录中获取其IVF-ET相关临床信息。在进入IVF-ET治疗周期前采集研究对象空腹静脉血,B超诊断IVF-ET治疗周期后临床妊娠情况。临床妊娠失败的研究对象归为妊娠失败组,成功获得临床妊娠的研究对象归于妊娠组。采用电感耦合等离子体质谱仪定量血清中15种稀土元素浓度,以稀土元素浓度的中位值分为高低浓度组,其中镥元素浓度≤ 2.2 pg/ml作为低浓度组,镥元素浓度> 2.2 pg/ml作为高浓度组。结果行IVF-ET后,临床妊娠失败38名,获得临床妊娠46名。妊娠失败组血清镥元素浓度中位数(P₂₅,P₇₅)[2.7 (1.8,3.3)pg/ml]显著高于妊娠组 [2.0 (1.3,2.8)pg/ml] (P < 0.05),其他元素两组分布差异均未见统计学意义。相比于镥元素较低浓度组(≤ 2.2 pg/ml),镥元素较高浓度组(> 2.2 pg/ml)粗比值比OR(95% CI)[3.3 (1.3~8.1 ) ],调整比值比OR(95% CI)[4.1 (1.5~10.9) ]。相比于血清镥元素浓度较低的研究对象,镥元素浓度较高的研究对象行IVF-ET失败的概率是其4.1倍。结论不孕症妇女血清中高浓度镥元素可能是造成行IVF-ET失败的危险因素之一。

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	程子茜
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	张敬旭

关键词 ：稀土元素, 血清, 体外受精-胚胎移植, 不孕症

Abstract：Objective To study the association between the level of rare earth elements (REEs) of infertile women undergoing in vitro fertilization and embryo transfer (IVF-ET) and the risk of IVF-ET failure. Methods From Oct 2016 to May 2017, we adopted prospectively nested cohort study by recruiting a total of 84 valid women in Peking Univerisity People’s Hospital. A questionnaire was used to collect information regarding socio-demographic features. Clinical information related to IVF-ET was obtained from medical record. Fasting venous blood was collected before the treatment cycle. Clinical pregnancy was diagnosed using B-mode ultrasound after IVF-ET. The subjects of clinical pregnancy failure were classified as non-pregnanct group, and those who obtained clinical pregnancy successfully were regarded as pregnant group. A total of 15 REEs in serum were detected using inductively coupled plasma source mass spectrometer. REEs levels were divided into high and low concentration groups according to their median value (lutecium cut-off concentration: 2.2 pg/ml). Results 38 women did not achieve pregnancy after undergoing IVF-ET and 46 women conceived. We found that the serum lutecium concentration in the failure group [median value (P₂₅,P₇₅): 2.7 (1.8, 3.3)pg/ml] was significantly higher than that in the success group [2.0 (1.3, 2.8)pg/ml] (P<0.05). The crude odds ratio [ OR (95% CI): 3.3 (1.3-8.1)] and the adjusted odds ratio [adjusted OR (95% CI): 4.1 (1.5-10.9)] for women with high lutecium concentration (>2.2 pg/mL) compared to the reference women with low lutecium concentration (≤ 2.2 pg/mL) were both statistically significant. Women with higher lutecium level in serum was 4.1 times easier to get no pregnant during IVF-ET, compared to those with lower lutecium level. Conclusion High level of lutecium in serum may have an adverse effect on the IVF-ET success rate in infertile women.

Key words： rare earth elements serum in vitro fertilization and embryo transfer infertility

收稿日期: 2017-10-11

基金资助:国家自然科学基金(41401583)和国家关键技术研发项目(2015BAI13B06)

通讯作者: 张敬旭(jxzhang@bjmu.edu.cn)

引用本文:

程子茜, 鹿群, 谢婧, 刘莹颖, 强丽娟, 闫赖赖, 李智文, 王斌, 张敬旭. 不孕症妇女血清中稀土元素与体外受精-胚胎移植结局的关联性研究[J]. 中国生育健康杂志, 2018, 29(4): 327-332.
CHENG Zixi, LU Qun, XIE Jing, LIU Yingying, QIANG Lijuan, YAN Lailai, LI Zhiwen, WANG Bin, ZHANG Jingxu. Association of serum rare earth elements and the outcome of in vitro fertilization and embryo transfer among Infertile Women. Chinese Journal of Reproductive Health, 2018, 29(4): 327-332.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2018/V29/I4/327

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