反覆性經體外受精及胚胎植入後著床失敗之女性血清中之干擾素-γ較高

Increased serum IFN-γ in women with a history of repeated implantation failures after in vitro fertilization and embryo transfer

目的：本研究的目的是探討在反覆性經體外受精及胚胎植入後著床失敗女性與正常生育女性血清細胞激素濃度，包括干擾素-γ，腫瘤壞死因子-α，介白質-4及介白質-10。方法：24位反覆性體外受精著床失敗女性及40位正常生育女性，以Luminex-based cytokine assays測定血清干擾素-γ，腫瘤壞死因子-α，介白質-4及IL-10濃度。結果：24位反覆性體外受精著床失敗女性干擾素-γ血清濃度比40位正常生育女性高 （中位數38.50 pg/mL，四分位距2.44-86.73 pg/mL vs. 中位數2.44 pg/mL，四分位距 2.44-47.01 pg/mL，p<0.05）。反覆性體外受精著床失敗女性干擾素-γ/介白質-4比值比正常生育女性高 （中位數7.7，四分位距 1.0-21.1 vs. 中位數2.9，四分位距 1.0-8.4，p<0.05）。結論：反覆性經體外受精及胚胎植入後著床失敗女性之血清干擾素-γ濃度及干擾素-γ/介白質-4比值比正常生育女性高，顯示胚胎著床失敗的病理機轉可能與偏向Th1免疫狀態相關。

Objective: To compare serum cytokines, including interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4) and IL-10, between non-pregnant women with repeated implantation failures (RIFs) after in vitro fertilization and embryo transfer (IVF-ET) cycles and those with normal fertility during late follicular phase. Methods: Serum levels of IFN-γ, TNF-α, IL-4 and IL-10 in 24 women with RIF and 40 women with normal fertility were measured using Luminex-based cytokine assays. Results: A significantly higher serum level of IFN-γ was observed in women with RIF (median = 38.50 pg/mL, interquartile [IQ] range 2.44-86.73 pg/mL) than in controls (median = 2.44 pg/mL, IQ range 2.44-47.01 pg/mL, p<0.05). A significantly higher IFN-γ/IL-4 ratio was observed in women with RIF (median = 7.7, IQ range 1.0-21.1) than in controls (median = 2.9, IQ range 1.0-8.4, p<0.05). Conclusion: A significantly higher serum IFN-γ and IFN-γ/IL-4 ratio in women with RIF after IVF-ET cycles might suggest skewed Th1 immune status was possibly associated with the pathogenesis of implantation failures.