| Objective To investigate the role of Granulocyte-Macrophage colony-stimulating Factor (GM-CSF) and the sex hormones in the follicular fluid (FF) on the day of ovum pick-up(OPU) during controlled ovarian hyper-stimulation (COH) cycles and the influences on follicle development, ovulation, fertilization and embryo quality during in-vitro fertilization and embryo transfer(IVF-ET) cycles.Methods 60 women underwent IVF-ET because of tubal infertility undercontrolled hyper- stimulation with GnRHa/FSH/HMG/HCG. FF and the Ooeytes were collected during transvaginal oocyte retrieval and 4 of these 60 subjects had serial sera obtioned on several occasions. GM-CSF in the FF and serum were measured by enzyme-linked immunosorbent assay(ELISA) and estradiol (E2) , progesterone (P) and lutropin(LH) concentrations were measured by an enzyme immunoassay (EIA), The maturity and fertilization of the oocytes were observed, and ultrasonography performed to confirm clinical pregnancies 4 weeks after the embryo transfer. The overall recorded date were treated statistically by the SPSS Microsoft.Results (1)42 mature and 15 immature OCCC were obtained in the FF of 60subjects , another 3 were postmature. These oocytes were cultured together with serm.Then the rate of fertilization and cleavage of oocytes were observed, and compared between the 2 groups. There are 43 oocytes fertilized and 12-non- fertilized ,38 cleaved and 17 non- cleaved .The ultrasonography performed to confirm clinical pregnancies 4 weeks after the embryo transfer containing mature oocytes,9 women were pregnant.(2)In the FF containing mature oocytes, the concentractions of GM-CSF, progesterone and lutropin were significantly higher than those in the FF with immature oocytes 1346.2±43.6) Ku/lvs (1086.4±28.3) Ku/1, (0.72±0.35) mIu/ml vs(0.54±0.21) mIu/ml,(33787±16420.8)ng/ml vs (17188.1±8107.4) ng/ml, P<0.05 respectively], The mean concentractions of GM-CSF, progesterone and lutropin in the FF from fertilized subjects were obviously higher than those in the FF from nonfertilized subjects [(1346.2±34.7) Ku/lvs (1175.4.4±37.3) Ku/1 ,(0.73±0.35) mlu/ml vs(0.53±0.21) mIu/ml,(33832.1±17095.2)ng/ml vs (19410.6±8607.6) ng/ml, P<0.05 respectively] and in subjects with pregnancy, higher mean concentrations of GM-CSF and lutropin were detected as compared with the concentrations measured from non-pregnancy subjects[(1437.7±37.7) Ku/1 vs.(1035.9±36.8) Ku/1, (0.73±0.41 ) mlu/ml vs(0.53±0.23) mlu/ml,P<0.05 respectively], However, there are no significant difference in the concentractions of GM-CSF, progesterone and lutropin between the cleaved and non-cleaved group, the high and low embryo grade groups[ (1273.2±42.7) Ku/1 vs (1174.9±38.5) Ku/1 , ( 0.64±0.49 ) mlu/ml vs(0.54±0.22) mIu/ml,(31767.1±8942.4)ng/ml vs (23384.3±6624.6) ng/ml, P>0.05 respectively] , [ ( 1324.8±32.3)Ku/1 vs ( 1274.7±38.7 ) Ku/1 , ( 0.63±0.37 ) mlu/ml vs(0.54±0.23) mIu/ml,(33774.1±11923.3)ng/ml vs (22742.4±7695.7) ng/ml, P>0.05 respectively]; Estradiol concentrations in the FF seemed to undergo no obvious changes during the whole procedue, and evinced no significant differences betweenthe groups.Conclusion The level of GM-CSF and the higher lutropin in the follicularfluid (FF) on the day of ovum pick-up(OPU).during COH cycles may play an important role in the process of follicle development , maturation and fertilization, but not in the embryo quality during IVF-ET cycles. Higher lutropin and progesterone concentrations in the FF on the day of OPU may promote oocyte maturation, while GM-CSF and lutropin levels to be associated with the maturation and fertilization of the oocytes, and may be indicative of the IVF outcome. The level of GM-CSF in FF may be regulated by estradiol. |
