| Endometriosis is a common benign gynecological disease,characterized by pain and infertility,which seriously affects the quality of life of women of childbearing age.With the rapid development of assisted reproductive technology?ART?in recent years,an increasing number of infertility patients with endometriosis choose ART to achieve their fertility require.At the same time,with the in-depth study on the mechanism of infertility caused by endometriosis,more and more evidence suggest that growth hormone?GH?may play an important regulatory role in the treatment of infertility patients with endometriosis.Objective: To investigate the effects of growth hormone on clinical outcomes and oxidative stress in patients with endometriosis infertility,the levels of reactive oxygen species?ROS?and total antioxidant capacity?TAC?in serum,follicular fluid and granulosa cell homogenate were detected on the day of ovum collection in endometriosis patients inteivened by growth hormone,and the growth hormone intervention was carried out on granulosa cells cultured in vitro.Methods:1.93 cycles of EMs patients undergoing IVF-ET in the reproductive medicine department of the second hospital of Hebei Medical University from January 2017 to December 2019,were analyzed retrospectively.According to whether GH was used,they were divided into GH group?group A?and non GH group?group B?.The basic characteristics,clinical,laboratory characteristics and outcomes of?embryo transplantation of group A and B were compared.2.Among them,33 cycles of EMs patients from September to December 2019 were divided into A1 group and B1 group according to whether GH was used or not.The levels of ROS and TAC in serum,follicular fluid and granulosa cell homogenate were measured by enzyme linked immunosorbent assay?ELISA?,and the ratio of ROS / TAC was calculated.3.According to whether GH was used or not,the granulosa cells cultured in vitro were divided into four groups: growth hormone treated 24h?L-24h?group,growth hormone treated 48h?L-48h?group,matching the two time is 24 h control?C-24h?group and 48 h control?C-48h?group.The ROS and TAC levels in culture medium and granulosa cell homogenate were measured by ELISA,and the ROS / TAC ratio was calculated and compared ROS level,TAC level and ROS / TAC ratio of each group.Results: 1.Comparison of the basic characteristics between group A and group B: There were no significant difference on comparing the ages,years of infertility,the types of infertility,body mass index,the basal levels of follicle stimulating hormone?FSH?,estradiol?E2?,luteinizing hormone?LH?,progesterone?P?,prolactin?PRL?and testosterone?T?,sinus follicle number between the two groups?P>0.05?.Comparison of the clinical outcomes between group A and group B: There was no significant difference in total gonadotropin dosage,gonadotropin duration,the serum estradiol?E2?level,the serum luteinizing hormone?LH?level and the serum progesterone?P?on HCG injection day?P>0.05?.Comparison of the laboratory characteristics between group A and group B: the retrieval oocytes number,rate of fertlization,rate of 2PN fertilization,rate of 2PN cleavage and the rate of transferable embryos were 12?8.3?vs 10?8.0?,83.30% vs 80.94%,65.4% vs 61.3%,98.9% vs 97.8%,48.1% vs 45.3%,the group A were higher than those in group B,but they had no statistical significance?Z=-0.693,P>0.05;?2=1.044,P>0.05;?2=1.947,P>0.05;?2=2.557,P>0.05;?2=0.543,P>0.05?.The rate of good-quality embryos between group A and group B was 31.0%vs 23.9%,group A was higher than that in group B and the difference had statistical significance??2=4.269,P<0.05?.Comparison of the outcomes of?embryonic transplantation between group A and group B: the implantation rate and clinical pregnancy rate of two groups were 33.9% vs 27.5%%,44.8% vs 42.9%,the group A was higher than that in group B.The abortion rate of two groups was 23.1%vs 26.7%,the group A was lower than that in group B,but no statistical significance.2.Comparison of the ROS?level,TAC level and ROS/TAC score in?serum?between group A1 and group B1: the levels of ROS,the levels of TAC and the ratios of ROS/TAC of two groups respectively were 0.98±0.16ng/ml vs 1.05±0.10ng/ml,1.50±0.10ng/ml vs 1.51±0.13ng/ml,0.66±0.11 vs 0.70±0.10,with no statistical significance.Comparison of the ROS?level,TAC level and ROS/TAC score in?follicular fluid?between group A1 and group B1: the levels of ROS of two groups were 0.96±0.24ng/ml vs 1.07±0.13ng/ml,with no statistical significance.The levels of TAC and ratios of ROS/TAC of two groups respectively were 1.29±0.23ng/ml vs 1.00±0.08ng/ml,0.75±0.18 ng/ml vs 1.07±0.11 ng/ml and with statistical significance?t=4.790,P<0.05;t=6.159,P<0.05?.Comparison of the ROS?level,TAC level and ROS/TAC score?in granulosa cell homogenate between group A1 and group B1: the levels of ROS,the levels of TAC and the ratios of ROS/TAC of two groups respectively were 0.96?0.17?×10-6ng/cell vs 0.99?0.64?×10-6ng/cell,1.37?0.15?×10-6ng/cell vs 1.35?0.91?×10-6ng/cell,0.70?0.09?vs 0.82?0.91?,but there was no statistical significance.3.Comparison of the ROS?level,TAC level and ROS/TAC score in culture medium of vitro intervention group: the levels of ROS between group L-24 h and group C-24 h were 5.03±0.72ng/ml vs 6.29±0.54ng/ml,and it had statistical significance?t=3.141,P<0.05?.There was no significant difference in the level of TAC and the ratio of ROS/TAC between group L-24 h group and C-24 h.There was no significant difference in the level of ROS,the level of TAC and the ratio of ROS/TAC between group L-48 h and group C-48 h.Comparison of the ROS?level,TAC level and ROS/TAC score in?granulosa cell homogenate of vitro intervention group: the levels of ROS between group L-24 h and group C-24 h were 7.35±0.67 ng/ml vs 9.23±0.89ng/ml,and it had statistical significance?t=3.778,P<0.05?.There was no significant difference in the level of TAC and the ratio of ROS/TAC between group L-24 h group and C-24 h.There was no significant difference in the level of ROS,the level of TAC and the ratio of ROS/TAC between group L-48 h and group C-48 h.Conclusion:Growth hormone may reduce the level of reactive oxygen species in granulosa cells of patients with endometriosis,improve the antioxidant capacity,improve the development potential of oocytes,and thus improve the rate of high-quality embryos. |
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