The Research About Adipocytokines Expressed In PCOS And Associated With Apoptosis Of GC

Objective:The research will compare the levels of adipocytokines such as leptin, adiponectin, IGF-â… ,GH between polycystic ovarian syndrome group and control group in controlled ovarian hyperstimulation and find the relationship of adipocytokines, granulose cell apoptosis and pregnancy outcome in order to find the alteration of adipocytokines in follicular fluid and the function of adipocytokines on the oocyte development and pregnancy outcome. Methods: Among the patients of receiving ART treatment, we select 40 PCOS patients as study group, select 40 tubal infertility or male factor infertility patients as control group. We measure the level of leptin, adiponectin, IGF-1, GH in follicular fluid by enzyme linked immunosorbent assay, measure the level of estrogen, progestogen, androgen, follicle-stimulating hormone, luteinizing hormone, prolactin in follicular fluid by chemiluminescence determination,and measure the level of serum basal E2,P,T,FSH,LH,PRL and E2,P,LH,PRL on the day of injecting hCG by chemiluminescence determination. At the same time, we collect the granulose cell of control group when the oocyte retrieval assisted by ultrasound monitoring and detect the apoptosis rate by TdT-mediated dUTP-biotin nick end labeling (TUNEL) and detect the expression of apoptosis associated protein Bcl-2, Bax by immunohistochemistry. Results: 1.In different COH protocol, Gn consumption and leptin level of PCOS group is lower than control group. 2.Leptin level is correlated positively with Gn consumption and FSH level in FF. FF leptin increases as adding Gn consumption. 3. FF adiponectin level is correlated positively with FF androgen, but negatively with maturity rate. 4.There is no difference of FF GH level between study group and control group. In long protocol, IGF-â… level in FF of study group is higher than control group, and correlated positively with IVF fertility rate. There is no same result in short protocol. 5. The apoptosis rate of granulose cell(GC) ranges from 2% to 28%,and expresses equal in different groups. 6. The GC apoptosis rate is correlated negatively with oocyte maturity rate. 7.GC apoptosis rate increases when the level of serum progestogen on the day of injecting hCG rises. Oocyte maturity rate improves when GC apoptosis rate and BMI lessens. Conclusions: 1.After COH treatment, FF leptin level is lower in PCOS group than control group and increases as adding Gn consumption. It implies that FF leptin level is correlated with ovary reacitivity. 2. In FF, adiponectin lessens oocyte maturity rate by increasing androgen. 3. There is no difference of FF GH level between two groups. FF IGF-â… level varies in different COH protocol. It notes that the concentration and function of cytokins in serum or FF exsits diversity. 4.We have not found the relation between GC apoptosis and FF cytokines, gonadal hormones. It concerns interaction acting by multiple factor or small sample size. 5.The level of serum progestogen on the day of injecting hCG is the mark on predicting GC apoptosis rate. GC apoptosis rate and BMI can predict oocyte maturity rate.