Detalhes bibliográficos
Ano de defesa: |
2009 |
Autor(a) principal: |
Stevanato, Juliana [UNIFESP] |
Orientador(a): |
Não Informado pela instituição |
Banca de defesa: |
Não Informado pela instituição |
Tipo de documento: |
Tese
|
Tipo de acesso: |
Acesso aberto |
Idioma: |
por |
Instituição de defesa: |
Universidade Federal de São Paulo (UNIFESP)
|
Programa de Pós-Graduação: |
Não Informado pela instituição
|
Departamento: |
Não Informado pela instituição
|
País: |
Não Informado pela instituição
|
Palavras-chave em Português: |
|
Link de acesso: |
http://repositorio.unifesp.br/handle/11600/8911
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Resumo: |
Objective: to verify the relations between culture media concentrations of ammonia, alanine, glutamine, and alanyl-glutamine and embryo quality, pregnancy, and type of hormonal stimulation. Methods: a prospective case-control study was carried out including 62 embryos from 20 women submitted to assisted reproduction at the Sao Paulo Federal University. Inclusion criteria were age (up to 37 years old), one to four embryos transferred at day 3 of embryo culture, couples submitted to ICSI, and LH peak achieved through hCG administration. Experimental groups were subdivided according to embryo morphologic quality on days 2 and 3, homogenous (good embryos on days 2 and 3) or heterogeneous evolution, type of hormonal stimulation used (FSH or FSH and LH), and occurrence of pregnancy evaluated by serum ƒÒ-hCG. Culture media aliquots were collected after the embryos were transferred. Analysis of alanine, glutamine, alanyl-glutamine, and ammonia concentrations was performed using HPLC. Numerical variables were compared between groups using unpaired Student¡¦s T-test (heteroscedastic variables were transformed), and frequencies using Pearson¡¦s Chi-square or Fisher¡¦s exact test. Logistic models were constructed using female age, type of hormone used for stimulation, embryo quality, and the measured metabolites, in order to maximize predictability of occurrence of pregnancy. Data are presented as mean; standard deviation. Results: In the embryos transferred to women who achieved pregnancy, when compared to those who did not achieve pregnancy, lower levels of normalized glutamine (1.4; 0.7 and 1.9; 0.7, respectively, p=0.004) and ammonia (0.2; 0.01 and 0.3; 0.1, respectively, p=0.008) were observed. Higher levels or normalized alanyl-glutamine were observed in higher quality embryos on days 2 and 3, and on those who presented homogeneous evolution. Embryos from patients who received FSH with LH, when compared to those from patients who received only FSH, presented higher absolute values of alanyl-glutamine (334.9; 95.2 and 282.9; 62.4, respectively, p=0.017). In logistic regression, the model which best predicted pregnancy included all the normalized values of alanine, glutamine, age, type of hormone, and evolution (77.4% correct, p=0.00005). Conclusion: Our results allow us to conclude that, in our conditions: (i) embryos with better quality on days 2 and 3 and with a homogenous evolution are associated with higher contents of alanyl-glutamine in their culture media, (ii) lower levels of ammonia and glutamine in the culture media are associated to higher pregnancy rates, and (iii) FSH with LH during hormonal stimulation is associated to higher levels of alanyl-glutamine in the culture media. |