| 摘要: |
| ［摘要］ 目的 分析血清同源框基因A10（HOXA10）、粒细胞-巨噬细胞集落刺激因子（GM-CSF）、细胞质聚腺苷酸化元件结合蛋白1（CPEB1）对多囊卵巢综合征（PCOS）合并不孕症患者体外受精-胚胎移植（IVF-ET）后妊娠结局的预测价值。方法 招募2022年11月至2024年7月在黄河三门峡医院接受IVF-ET的125例PCOS合并不孕症患者作为研究对象。采集患者IVF-ET周期启动前（降调节前）的空腹静脉血，采用全自动生化免疫分析仪检测性激素水平。采用酶联免疫吸附试验检测血清HOXA10、GM-CSF、CPEB1水平。在IVF-ET 4周后行阴道超声检查评估妊娠结局，根据妊娠结局将患者分为妊娠组（58例）和妊娠失败组（67例）。采用多因素logistic回归分析妊娠结局的影响因素。通过受试者工作特征（ROC）曲线分析指标对妊娠结局的预测效能。结果 与妊娠组比较，妊娠失败组雌二醇（E2）、GM-CSF水平较低，睾酮（T）、HOXA10、CPEB1水平较高，差异有统计学意义（P<0.05）。多因素logistic回归分析结果显示，较高的HOXA10、CPEB1水平是PCOS合并不孕症患者IVF-ET后妊娠失败的危险因素（P<0.05），较高的GM-CSF水平是PCOS合并不孕症患者IVF-ET后妊娠失败的保护因素（P<0.05）。ROC曲线分析结果显示，HOXA10、GM-CSF、CPEB1水平均可有效预测PCOS合并不孕症患者IVF-ET后妊娠失败（P<0.05），且三者联合检测的预测效能［AUC（95%CI）=0.944（0.888～0.977）］优于单一指标（P<0.05）。结论 血清HOXA10、GM-CSF、CPEB1水平是PCOS合并不孕症患者IVF-ET后妊娠结局的影响因素，三者联合检测对妊娠结局具有较高的预测价值。 |
| 关键词: 多囊卵巢综合征 不孕症 粒细胞-巨噬细胞集落刺激因子 细胞质聚腺苷酸化元件结合蛋白1 同源框基因A10 体外受精-胚胎移植 妊娠结局 |
| DOI：10.3969/j.issn.1674-3806.2026.07.11 |
| 分类号:R 711.6 |
| 基金项目:三门峡市2022年科技发展计划项目（编号：2022001006） |
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| The value of serum HOXA10, GM-CSF and CPEB1 for predicting pregnancy outcomes after in vitro fertilization-embryo transfer in polycystic ovary syndrome patients complicated with infertility |
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Ji Wenwen, Tian Ying, Cao Zelei
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Department of Reproductive Medicine, Yellow River Sanmenxia Hospital, Sanmenxia 472000, China
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| Abstract: |
| ［Abstract］ Objective To analyze the value of serum homeobox A10(HOXA10), granulocyte-macrophage colony-stimulating factor(GM-CSF) and cytoplasmic polyadenylation element binding protein 1(CPEB1) for predicting pregnancy outcomes after in vitro fertilization-embryo transfer(IVF-ET) in polycystic ovary syndrome(PCOS) patients complicated with infertility. Methods A total of 125 PCOS patients complicated with infertility who received IVF-ET in Yellow River Sanmenxia Hospital from November 2022 to July 2024 were recruited as the research subjects. The patients′ fasting venous blood was collected before initiation of the IVF-ET cycle(before downregulation). Sex hormone levels were detected by using an automated biochemical immunoanalyzer. Serum levels of HOXA10, GM-CSF and CPEB1 were detected by using enzyme-linked immunosorbent assay(ELISA). Transvaginal ultrasound examination was performed to assess pregnancy outcomes 4 weeks after IVF-ET. According to the pregnancy outcomes, the patients were divided into pregnancy group(58 patients) and pregnancy failure group(67 patients). Multivariate logistic regression was used to analyze the factors influencing the pregnancy outcomes. The predictive efficacy of the indicators for pregnancy outcomes was analyzed by using receiver operating characteristic(ROC) curves. Results Compared with those in the pregnancy group, the levels of estradiol(E2) and GM-CSF in the pregnancy failure group were lower, while the levels of testosterone(T), HOXA10 and CPEB1 in the pregnancy failure group were higher, with statistically significant differences between the two groups(P<0.05). The results of multivariate logistic regression analysis showed that higher levels of HOXA10 and CPEB1 were risk factors for pregnancy failure in the PCOS patients complicated with infertility after IVF-ET(P<0.05), and a higher GM-CSF level was a protective factor for pregnancy failure in the PCOS patients complicated with infertility after IVF-ET(P<0.05). The results of ROC curve analysis showed that the levels of HOXA10, GM-CSF and CPEB1 could effectively predict pregnancy failure in the PCOS patients complicated with infertility after IVF-ET(P<0.05). Moreover, the predictive efficacy of the combined detection of the three indicators［AUC(95%CI)=0.944(0.888-0.977)］ was better than that of a single indicator(P<0.05). Conclusion Serum levels of HOXA10, CPEB1 and GM-CSF are the influencing factors of pregnancy outcomes in the PCOS patients complicated with infertility after IVF-ET. The combined detection of the three indicators has a high predictive value for pregnancy outcomes. |
| Key words: polycystic ovary syndrome infertility granulocyte-macrophage colony-stimulating factor(GM-CSF) cytoplasmic polyadenylation element binding protein 1(CPEB1) homeobox A10(HOXA10) in vitro fertilization-embryo transfer(IVF-ET) pregnancy outcomes |
