双酚A暴露对不同卵巢储备状态女性优质胚胎率的影响OACSTPCD

Objective:To explore impact of bisphenol A(BPA)on ovarian reserve and embryo quality during ovulation induction by using enzyme-linked immunosorbent assay(ELISA)to detect BPA level in follicular fluid of infertile patients with different ovarian reserve. Methods:The clinical data and follicular fluid of patients who accepted IVF-ET in the Reproductive Center of the First Hospital of Lanzhou University were collected.A total of 164 patients were selected,including 80 patients with normal ovarian reserve(NOR),39 patients with diminished ovarian reserve(DOR),and 45 patients with polycystic ovary syndrome(PCOS).The BPA level of follicular fluid was detected by ELISA.Based on the quartile of BPA concentration in follicular fluid,the patients in three groups were divided into subgroups(Q1-Q4 subgroups from low to high)for analysis.The effect of BPA on the good-quality embryo rate of women with different ovarian reserves was analyzed by univariate logistic regression analysis. Results:There were significant differences in age,basal FSH level,anti-Mullerian hormone(AMH)level,bilateral antral follicle count(AFC),and oocytes retrieval number among the three groups of patients(P＜0.05).The menstrual cycle length of the PCOS group was significantly longer than that of the other two groups(P＜0.05),and the basal LH level was significantly higher than that of the other two groups(P＜0.05).There were no significant differences in body mass index(BMI),infertility years,age of menarche,basal estrogen(E2)level,and fertilization mode among the three groups(P＞0.05).The concentration of BPA in the PCOS group was significantly higher than that in the DOR group[9.94(1.79,10.37)ppb vs.2.39(0.80,9.94)ppb,P＜0.05].There were no significant differences in BPA content between the NOR group and the other two groups(P＞0.05).In the NOR group,the good-quality embryo rate in the Q2 subgroup significantly decreased than the Q1 subgroup(30.65％vs.41.87％,P＜0.05).In the PCOS group,the good-quality embryo rate in the Q2 and Q4 subgroups was significantly lower than that in the Q1 subgroup(45.64％,37.99％vs.56.82％,P＜O.05).There was no significant difference in good-quality embryo rate among the subgroups of the DOR group(P＞0.05).The results of univariate Logistic regression analysis showed that BPA concentration in follicular fluid had no significant impact on good-quality embryo rate in all three groups(P＞0.05). Conclusions:BPA concentration in folliaular fluid has no significant relationship with the good-quality embryo rate in the women with different ovarian reserves.However,a decrease in the good-quality embryos rate was observed in the higher BPA concentration subgroup of NOR and PCOS patients,and it is still necessary to strengthen the prevention and control of potential risks caused by this substance.