神经肽Y、瘦素在超促排卵周期的变化

目的　探讨超促排卵周期中神经肽Y、瘦素水平的变化及其对卵泡发育的影响。方法　对 31例因输卵管因素不孕行体外受精 胚胎移植的患者采用相同超促排卵方案 ,用放射免疫法测定自然月经周期第 3～ 5天 (基础值 )、行垂体降调节后月经来潮第 3～ 5天 (启动日 )及取卵日血清卵泡刺激素 (FSH)、黄体生成素 (LH)、雌二醇(E2 )、孕酮 (P)、瘦素和血浆神经肽Y水平 ,并测定卵泡液中瘦素与神经肽Y水平。结果　在超促排卵周期中 :①瘦素水平上升 ,取卵日血清和卵泡液中瘦素水平极显著高于基础值 (P <0 .0 1) ,也显著高于启动日 (P <0 .0 5 ) ;②血浆神经肽Y水平下降 ,启动日显著低于基础值 (P <0 .0 5 ) ;取卵日血浆与卵泡液神经肽Y水平极显著低于基础值 (P <0 .0 1) ,同时也显著低于启动日 (P <0 .0 5 ) ;③卵泡液神经肽Y水平与卵泡数呈负相关 (r =- 0 .4 2 7,P =0 .0 17)。结论　超促排卵周期中 ,超生理水平的雌激素可能与瘦素水平升高有关 ;在卵巢水平瘦素与神经肽Y可能有相互协调的作用 ;持续使用外源性GnRH a可能对神经肽Y的产生有抑制作用

Leptin and neuropeptide Y levels in controlled ovarian hyperstimulation cycle and their effect on follicular development

Objective To investigate leptin and neuropeptide Y levels in controlled ovarian hyperstimulation cycle. Methods Ovulation was induced in 31 women who received in vitro fertilization and embryo transfer by the same program. The levels of FSH, LH, E 2, P, and leptin in serum and neuropeptide Y in plasma were measured by RIA. The venous blood was obtained on days 3～5 of spontaneous menstrual cycle (base level), days 3～5 after pituitary down regulation (start up day) and the day of oocyte pick up. The levels of leptin and neuropeptide Y in follicular fluid obtained from follicle aspiration were measured by RIA as well. Results In controlled ovarian hyperstimulation cycle: ①Leptin levels increased;on the day of oocyte pick up, both in serum and follicular fluid leptin concentrations were significantly higher than the base level ( P < 0.01 ) and start up day ( P < 0.05 ); ②Plasma neuropeptide Y levels declined, the levels of start up day were significantly lower than the base level ( P < 0.05 ), and both neuropeptide Y concentrations in plasma and follicular fluid on the day of oocyte pick up were significantly lower than the base level ( P < 0.01 ) and start up day ( P < 0.05 );③ Neuropeptide Y level in follicular fluid was negatively correlated with follicular number ( r= -0.427 ,P = 0.017 ) . Conclusion ①During controlled ovarian hyperstimulation cycle, estradiol may be related to leptin; there is some coordination between leptin and neuropeptide Y on the level of ovary; ②Continuous administration of exogenesis GnRH a may inhibit the production of neuropeptide Y.