| Objective: Polycystic ovarian syndrome (PCOS) is a frequent endocrine secretion disease in the femme of reproductive age, its incidence rate is 5%~10%. Its clinical features are menstruation irregularis, follicular atresia, persistence of anovulation or oligotrichia ovulation, moreover usuall accompanying with high spontaneous abortion rate. The development mechanism of PCOS is not very clear, furthermore it is hard spot and hot spot currently. The most investigations presume, PCOS is a disease of metabolism and endocrine disturbance, referring to internal hormone, metabolism, immunization, familia heredity etc. In recent years ,more and more researches show that matrix metalloproteinase-2,MMP-9 and tissue inhibitor of matrix metalloproteinase-1 play an important role in the development mechanism of polycystic ovarian syndrome. The aim of this study is to measure the level of MMP-2,MMP-9 and TIMP-1 in the follicular fluid of PCOS and normal patients who receive in vitro fertilization-embryo transfer(IVF-ET). The normal patients were who with eumenorrhea but because other causes leading to infertility . Approaching what to result in follicular atresia and high spontaneous abortion rate. Thereby the study may provide the rationale for the chinic treatment.Methods1 The study subject1.1 The PCOS group(The study group): To select 20 patients with polycystic ovarian syndrome who undergone IVF-ET because of infertility in the Second Hospital of HeBei Medical University from Jan 2006 to Aug 2006,their mean age were 29.7±5.1 years old.1.2 The control group: To random select 20 patients who undergone IVF-ET because of infertility, from Jan 2006 to Aug 2006.The patients with eumenorrhea but because fallopian tube causes leading to infertility, and their elementary hormone FSH,LH,E2,PRL,T(MC:3day) within normal limits. Their mean age were 31±5.52 years old.The patients of PCOS group and control group shoule be the first time to receive ovaian stimulation and long down-regulated protocols, GnRH-a/Gonal-F/HMG/HCG.2 Methods and Contents.2.1 Collecte the sample: On the basis of Doppler ultrasound and urine LH test paper fixed quantity partly and the level of LH,E2 to measure follicula development. When Doppler ultrasound shows one egg diameter≥18mm, two eggs diameter≥17mm,or three eggs diameter≥16mm, then 21:00 to give HCG5000-10000iu muscle injection. Obtaining eggs 36 hours later.The follicular fluid of PCOS individual in one cycle was collected together. Centrifugalizating in one time(2000r/5min, ordinary temperature), reciping clear supernatant liquid(SN) -20℃to reserve, later to measure the levels of MMP-2,9,TIMP-1. Using the same principle to handle the follicular fluid of control group.2.2 Mensurate the sample: To operate ELISA(enzyme-labeled immunosorbent assay) to mensurate the level of MMP-2,9,TIMP-1 in follicular fluid.2.3 Mensurate endocrine secretion:(1)Taking venous blood of PCOS group and control group with empty stomach (Mense:3day), using Chemistry illuminate method to mensurate follicle stimulating hormone (FSH), luteotropic hormone (LH), estradiol (E2), progestogen(P), testosterone (T)of the basis blood.(2)Taking venous blood of PCOS group and control group in HCG day, mensurating LH, E2.Results1 Levels of FSH,E2,LH,T,PRL1.1 To compare outcomes of FSH,E2,PRL: The mean of FSH,E2,PRL in PCOS group were(5.34±0.72mIU/ml),(20.59±3.41pg/ml),(13.44±1.79ng/ml), and in control group were(7.12±1.35mIU/ml),(32.09±2.67pg/ml),(14.27±2.16ng/ ml ), there is no statistical significance in two sets (P>0.05). (MC: 3day)1.2 To compare outcomes of LH,T,LH/FSH: The mean of T,LH in PCOS group were (0.72±0.11nmol/ml),(10.89±0.96mIU/ml) and in control group were (0.34±0.08nmol/ml), (4.68±0.19mIU/ml), LH/FSH was 2~3 in PCOS and LH/FSH was 0.8~1.1 in control group, there were remarkably statistical significance in two sets(P>0.05). (MC: 3day)1.3 To compare outcomes of LH,E2 in HCG Day: The mean of LH,E2 in PCOS group were (10.89±2.31mIU/ml),(1121.1±119.04pg/ml ) and in control group were (8.76±1.74 mIU/ml),(1062±121.4pg/ml) , there is no statistical significance in two sets (P>0.05).2 Levels of MMP-2,MMP-9,TIMP-1 in follicular fluid.2.1 To compare outcomes of MMP-2: The mean of MMP-2 in the follicular fluid of PCOS was higher than its in the control group.[(52.886±2.906ng/ml)vs(39.805±0.8587ng/ml) P<0.05] . There were remarkably statistical significance.2.2 To compare outcomes of MMP-9: The mean of MMP-2 in the follicular fluid of PCOS was higher than its in the control group.[(47.200±1.4277ng/ml)vs(37.107±0.7330ng/ml) P<0.05]. There were remarkably statistical significance.2.3 To compare outcomes of TIMP-1: The mean of TIMP-1 in the follicular fluid of PCOS was lower than its in the control group.[(37.720±0.3748ng/ml)vs(40.942±0.4705ng/ml) P<0.05]. There were remarkably statistical significance.3 There was a negative correlation between the expression of TIMP-1 and MMP-9, TIMP-1 and MMP-2. There was a positive correlation between the expression of MMP-2 and MMP-9.4 To compare outcomes of MMP-2,MMP-9,TIMP-1 in in pregnancy group and non- pregnancy group .4.1 To compare outcomes of MMP-2: The mean of MMP-2 in the follicular fluid of pregnancy group(16) is (42.130±0.4417ng/ml) and in non-pregnancy group(24) is (41.336±0.9201ng/ml).There was no significant deviation, we can think there is no statistical significance in two sets (P>0.05).4.2 To compare outcomes of MMP-9: The mean of MMP-2 in the follicular fluid of pregnancy group(16) is (43.357±0.5762ng/ml) and in non-pregnancy group(24) is (41.336±0.9201ng/ml).There was no significant deviation, we can think there is no statistical significance in two sets (P>0.05).4.3 To compare outcomes of TIMP-1: The mean of TIMP-1 in the follicular fluid of pregnancy group(16) is (38.572±0.6753ng/ml) and in non-pregnancy group(24) is (38.796±0.7627ng/ml).There was no significant deviation, we can think there is no statistical significance in two sets (P>0.05).Conclusions1 The level of LH,T,LH/FSH in PCOS group is obviously higher than its in control group,but the level of FSH,E2,PRL there was no significant deviation.(MC:3day). There was no significant deviation of the level of LH,E2 .(HCG Day)2 In the same condition: the level of MMP-2,MMP-9 in the follicular fluid of PCOS group is obviously higher than its in control group ,but the level of TIMP-1 in the follicular fluid of PCOS group is lower than its in control group. To hint: we could conclude MMP-2,MMP-9 and TIMP-1 play a improtant role in the mechanism of polycystic ovary syndrome, especially leading to high spontaneous abortion rate and follicular atresia . The conclusion provide rationale for us to supply pregnancy hormone to PCOS patient who had been conceived.3 There was a negative correlation between the expression of TIMP-1 and MMP-9, MMP-2. There was a positive correlation between the expression of MMP-2 and MMP-9.4 There was no significant deviation of the levels of MMP-2,MMP-9,TIMP-1 in pregnancy group and non- pregnancy group . |
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