多囊卵巢综合征不孕患者血清和卵泡液中Neuregulin-4水平与胚胎质量的相关性分析OA

Objectives:To investigate the correlation between the levels of the adipokine neuregulin-4(NRG4)in serum and follicular fluid and embryo quality in infertile patients with polycystic ovary syndrome(PCOS). Methods:A total of 66 PCOS patients who underwent in vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET)treatment at the Reproductive Center of Xuzhou Central Hospital from March 2023 to February 2024 were enrolled as the PCOS group.Concurrently,74 non-PCOS patients undergoing IVF/ICSI due to male factor or tubal factor infertility were selected as the control group.General data,hormone levels,glucose and lipid metabolism indicators,ovulation induction outcomes,fertilization and embryo culture status,and pregnancy outcomes were collected.Serum and follicular fluid NRG4 levels were measured using enzyme-linked immunosorbent assay(ELISA).Pearson correlation analysis was employed to assess the correlation between serum and follicular fluid NRG4 levels and embryo quality. Results:The PCOS group exhibited significantly higher infertility duration,body weight,and body mass index(BMI)compared to the control group(P＜0.05).Levels of luteinizing hormone(LH),anti-Müllerian hormone(AMH),testosterone(T),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),fasting insulin,and apolipoprotein B(APOB)were significantly higher in the PCOS group(P＜0.05),whereas levels of follicle-stimulating hormone(FSH),high-density lipoprotein cholesterol(HDL-C),and apolipoprotein A(APOA)were significantly lower(P＜0.05).The numbers of oocytes retrieved,fertilized oocytes,two-pronuclear(2PN)zygotes,cleaved embryos,2PN cleaved embryos,available embryos,high-quality embryos,cultured blastocysts,and formed blastocysts were significantly higher in the PCOS group than those in the control group(P＜0.05).However,the rates of fertilization,2PN fertilization,cleavage,2PN cleavage,blastocyst formation,and high-quality blastocyst formation were significantly lower in the PCOS group(P＜0.05).The clinical pregnancy rate was significantly lower in the PCOS group compared to the control group(P＜0.05).NRG4 levels in serum and follicular fluid were significantly higher in the PCOS group than those in the control group(P＜0.05).Pearson correlation analysis revealed that NRG4 levels in serum and follicular fluid were significantly negatively correlated with embryo quality indicators(P＜0.05). Conclusions:NRG4 levels in serum and follicular fluid are elevated in infertile patients with PCOS and are negatively correlated with embryo quality parameters,indicating NRG4 levels are correlated with embryonic developmental proficiency.