褪黑素提高卵巢储备功能低下患者卵子质量的作用及其机制研究

Diminished Ovarian Reserve (DOR) is a disease that the patient with which have less eggs and poor quality eggs. According to statistics, there have still been about 10% of patients with infertility troubled by DOR. Although the technique of In Vitro Fertilization-Embryo Transfer （IVF-ET）is the most effective one in solving people infertility, but the clinical pregnancy of DOR patient is always poor because of the decrease of egg number and egg quality. Our previous results showed repeated implantation failure added much metal stress on DOR patients, and more, the ovarian reserve function could be decreased by the continual overstimulation to ovarian, and even develop to Premature Ovarian Failure (POF). Therefore, how to increase the egg number retrived from DOR patients, improve the quality of eggs and get more high-quality embryos is the key to solve the problem of infertility before it is going to be worse. Previous studies of us had found that exogenous melatonin (MLT) could improve the number and quality of mice oocytes in stimulation cycle. However, up to now, there are few reports about MLT implication and its mechanism in DOR patients. In this study, we would interpret the effect of MLT on improvig the ovarian function and oocyte quality of DOR patient, and analye the mechanism from its antioxidant capacity and effect on mental stress. According to our study, we can get a new and safe method in improving the clinical pregnancy rate of DOR patient effectivly, and provide a theoretical reference for improvig ovarian function of other women.

DOR是指卵巢产生卵子的能力减弱，卵子质量下降。DOR患者约占不孕不育患者的10%。虽然IVF-ET技术是目前治疗不孕不育症最为有效的方法，但是DOR患者获卵数少，卵子质量差，导致其周期妊娠率较低，长期治疗效果差。我们前期研究发现反复妊娠失败极大的增加了患者的心理压力，而且促排药物对卵巢的过度刺激往往会加重卵巢储备功能的下降，甚至发展为卵巢早衰。因此，如何在病情恶化前增加DOR患者的获卵数，提高卵子质量，获得更多优质胚胎是解决其不孕问题的关键。项目组前期工作证实小鼠口服褪黑素（MLT）可增加促排周期获卵数，且显著提高卵子质量。然而，尚无相关文献报道MLT在DOR患者的应用及其作用机制。本研究欲通过DOR患者口服MLT来改善其卵巢功能，提高其卵子质量，并从MLT的抗氧化能力及可能在缓解心理压力等方面的效果探讨其作用机制。通过本研究可建立一种安全有效的、提高DOR患者临床妊娠率的新方法。