Study The Effect Of MCM4 And Related Factors On IVF-ET Pregnancy Outcome

?Objective? In order to further improve the clinical pregnancy rate of in vitro fertilization-embryo transfer(IVF-ET),and explore the pathogenesis of infertility from the perspective of molecular biology.We integrated the previous research results then screened the genes corresponding to minichromosome maintenance protein 4(MCM4)as the research object,and confirmed its dynamic changes during the whole in vitro fertilization-embryo transfer cycle,analyzed its changes and other factors,so as to provide ideas for clinical diagnosis and treatment.?Methods? This study selected these infertility patients who have done IVF-ET treatment in the Department of Reproductive Medicine,the First Affiliated Hospital of Dali University,during June 2017 to December 2017.We divided them into two groups according to the pregnancy outcome,the pregnancy success group and the pregnancy failure group,each group had 20 patients.All patients were treated with standard long-term regimen for controlled ovarian stimulation.Follicular development was monitored by vaginal ultrasound.After follicular maturation,the eggs were taken under ultrasound guidance.After 18 hours of routine in vitro fertilization,the results of fertilization were observed.Evaluation of embryo grading and fragments were done after 66-68 hours of IVF,then selected high-quality embryos for transplantation.The pregnancy outcome were judged by serum ?-hCG level which were detected 15 days after transplantation.Collect relevant clinical data of all subjects(age,infertility years,body mass index,anti-mullerian hormone,follicle stimulating hormone,luteinizing hormone,estradiol,progesterone,human chorionic gonadotropin,total dosage of gonadotropin,controlled ovarian hyperstimulation days,antral follicle count,the number of obtained eggs,fertilization rate,the number of obtained embryos,the number of high-quality embryos,high-quality embryo formation rate,the number of transplanted embryos,proportion of high-quality embryos in transplanted embryos,etc.RNA was extracted from lymphocyte in peripheral blood samples from different groups during the treatment(the pre-IVF-ETstage,Stage I;ovarian stimulation start stage,Stage II;15 days after embryo transfer,Stage III),then the expression of MCM4 mR NA was detected by real-time PCR.Analyze relevant clinical data and MCM4 results which affectted the pregnancy outcome of in vitro fertilization-embryo transfer was found out.?Results? 1.Comparison of general data between the two groups: There was no significant difference in the general data,age,body mass index(BMI),infertility years and anti-Mullerian hormone levels between the two groups(P>0.05).2.Comparison of hormone levels in patients at each experimental stage: There were no significant differences in the levels of follicle stimulating hormone,luteinizing hormone,progesterone and estradiol between Stage I and Stage II in the two groups(P>0.05).But there was a statistically significant difference in the levels of progesterone and human chorionic gonadotropin(P<0.05).3.Comparison of ovulation induction: The total dosage of Gn and the number of COH days in the pregnancy failure group were higher than that of the pregnancy success group(P<0.05).However,there was no significant difference in antral follicle count between the two groups(P>0.05).4.Comparison of the obtained total eggs and embryos: The number of MII eggs,the number of obtained embryos and the number of high-quality embryos in the pregnancy success group were higher than those in the pregnancy failure group.The difference was statistically significant(P< 0.05),but the difference in the total number of obtained eggs between the two groups was not statistically significant(P>0.05).There was no significant difference in fertilization rate and quality embryo formation rate between the two groups(P>0.05).5.Comparison of transplantation: There was no significant difference in the number of transplanted embryos and the endometrial thickness at the time of transplantation between the two groups(P>0.05).There was no significant difference in the ratio of superior embryos,endometrial classification and mucus hemorrhage during transplantation between the two groups(P>0.05).6.Comparison of MCM4 expression in patients at each experimental stage: Calculated by comparing Ct method,the expression of MCM4 mR NA in the pregnancy success group was significantly higher than that in the pregnancy failure group during Stage I and Stage III(P<0.05).The expression of MCM4 mR NA in the pregnancy success group at Stage III was significantly lower than that at Stage I andStage II(P<0.05).?Conclusion? 1.The basal hormone levels of infertility patients in this study could not predict IVF-ET pregnancy outcomes.2.higher gonadotropin(Gn)dosage and longer control ovulation(COH)duration will affect the oocyte maturity and oocyte quality of infertility patients.3.If the number and quality of transplanted embryos are roughly equivalent and the endometrial thickness ?8 mm,the endometrial thickness during transplantation cannot predict the IVF-ET pregnancy outcome.It should be considered to apply a full-time dynamic endometrial test and give manual intervention when needed.4.Higher HCG and progesterone levels,more MII oocytes,embryos and high quality embryos,with high expression of MCM4 at Stage I and Stage II are favorable factors for pregnancy.Higher gonadotropins dosage and longer control ovulation duration are harmful factors for pregnancy.