07 aug. 2008 CONCENTRATIILE SERICE SI FOLICULARE ALE VEGF, LIF SI NO SI RELATIA LOR CU REZULTATELE FIV-ET
R. Micu*, M. E. Hammaden**
*Clinica de Obstetricã si Ginecologie I, UMF “Iuliu Hatieganu” Cluj-Napoca
**Universitaet Frauenklinik Homburg/Saar, Germania
Rezumat
Obiectivul studiului a fost sã se determine concentratiile serice si în lichidul follicular ale VEGF, LIF si oxidului nitric ale pacientelor ce urmeazã proceduri de fertilizare în vitro, pe de o parte si sã compare valorile acestor parametric ai pacientelor ce au obtinut sarcina cu valorile celor care nu au reusit sã o obtinã.
Material si metodã: 75 de paciente supuse procedurii FIV au fost incluse în acest studiu. Serul si lichidul follicular au fost prelevate la momentul punctiei foliculare si congelate la -80˚C cu scopul de a fi utilizate ulterior pentru determinarea concentratiei LIF si VEGF prin tehnica ELISA. Activitatea NO a fost evaluatã în mod indirect prin reactia Griess ce mãsoara metabolitii nitrat/nitrit.
Rezultate: 19 paciente au obtinut sarcina, în timp ce 56 nu au reusit. Concentratiile medii serice ale VEGF, LIF si NO la pacientele ce au obtinut sarcina au fost de 324.2+/- 157.1pg/ml; 4.1+/-3.6pg/ml si 38.4+/-19.3µmol/L în comparatie cu 386.6+/- 180.1pg/ml; 3.1+/-2pg/ml si 36.2+/-16.4µmol/L, la pacientele gravide, diferentele fiind nesemnificative. Concentratia folicularã a VEGF si LIF a fost semnificativ mai mare decât cea sericã în ambele loturi p=0.005, respective p=0.01. Nu am gãsit diferente semnificative între concentratiile NO din ser sau lichid follicular.
Concluzii: datele sugereazã o posibilã implicare a VEGF si LIF în foliculogeneza si corelarea nivelurilor foliculare ale acestor douãcitokine cu ratã crescutã de sarcini. În schimb nivelurile serice de VEGF, LIF si NO nu sunt markeri eficienti cu privire la receptivitatea endometrului.
Abstract
Objective: To determine the serum and follicular fluid concentrations of VEGF, LIF and nitric oxide of patients who were to undergo IVF procedures as against similar parameters of patients who had become pregnant and those who would not.
Materials and Methods: 75 patients who had undergone IVF procedures were included in this study. Samples of serum and follicular fluid were taken during follicular aspiration and kept at -80˚C with the aim of being analyzed later for LIF and VEGF concentrations using the ELISA technique. The NO activity was evaluated indirectly by the Griess reaction which measures the Nitrate/Nitric metabolites.
Results: 19 patients became pregnant whilst 56 were not successful. The mean serum concentrations of VEGF, LIF and NO in patients who became pregnant were 324.2+/- 157.1pg/ml; 4.1+/-3.6pg/ml si 38.4+/-19.3µmol/L as compared to 386.6+/- 180.1pg/ml; 3.1+/-2pg/ml si 36.2+/-16.4µmol/L in the non-pregnant patients, the differences being insignificant. The follicular concentrations of VEGF and LIF were significantly greater than the serum concentrations in both groups, p=0.005 and p=0.01, respectively. No significant difference between the serum and the follicular fluid concentrations were seen.
Conclusions: The data suggests a possible role for VEGF and LIF in folliculogenesis and a correlation of follicular levels of these cytokines to higher rates of pregnancy. On the other hand, the serum levels of VEGF, LIF and NO are not adequate markers for endometrial receptivity.