한국 불임 여성에서 난포자극호르몬 수용체 유전자형과 체외수정 및 배아이식술 임상 결과와의 관련성

Relationship between FSH Receptor Genotype and Clinical Outcomes of IVF-ET in Infertile Korean Women

  • 문미혜 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 최혜원 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 김민지 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 이형송 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 차선화 (관동대학교 의과대학 제일병원 산부인과학교실) ;
  • 송인옥 (관동대학교 의과대학 제일병원 산부인과학교실) ;
  • 궁미경 (관동대학교 의과대학 제일병원 산부인과학교실) ;
  • 전진현 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실)
  • Moon, Mi-Hye (Laboratory of Reproductive Biology & Infertility, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Choi, Hye-Won (Laboratory of Reproductive Biology & Infertility, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Kim, Min-Jee (Laboratory of Reproductive Biology & Infertility, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Lee, Hyoung-Song (Laboratory of Reproductive Biology & Infertility, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Cha, Sun-Hwa (Department of Obstetrics and Gynecology, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Song, In-Ok (Department of Obstetrics and Gynecology, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Koong, Mi-Kyoung (Department of Obstetrics and Gynecology, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Jun, Jin-Hyun (Laboratory of Reproductive Biology & Infertility, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine)
  • 발행 : 2008.03.30

초록

목 적: 본 연구에서는 한국 불임 여성의 난포자극호르몬 수용체 유전자형의 분포 빈도를 파악하고, 체외수정 시술에서 난포자극호르몬 수용체 유전자형에 따른 과배란 유도 과정에서의 난소 반응과 각종 임상 결과와의 관련성을 알아보고자 하였다. 연구방법: 연구대상은 제일병원에 내원한 여성 불임 환자 1, 020명을 대상으로 난포자극호르몬 수용체의 유전자형, 즉 Thr307Ala (T/A)과 Asn680Ser (N/S)을 조사하였으며, 이들 중에서 과배란 유도와 체외수정 및 배아이식술을 시행한 302주기에서의 임상 결과를 이들의 유전자형에 따라 비교하였다. 결 과: 대상 환자에서 난포자극호르몬 수용체의 Thr307Ala와 Asn680Ser의 유전자형 빈도는 TT/NN 군이 44.80% (n=457), TA/NS 군이 41.96% (n=428) 그리고 AA/SS군이 10.49% (n=107)의 분포로 조사되었다. 과배란 유도에서의 각 유전자형에 따른 대상 환자의 나이, 난소 반응에 관련된 사용한 난포자극호르몬의 용량과 이에 따른 혈중 에스트라디올의 농도와 채취된 난자의 수 등에서 통계적으로 유의한 차이가 나타나지 않았다. 그러나 배아이식 후 AA/SS 유전자형 환자에서의 착상률이 TT/NN에 비해 통계적으로 유의하게 높게 나타났다 (24.5% vs 15.7%, p<0.05) 결 론: 대표적인 세 가지 TT/NN, TA/NS 그리고 AA/SS 유전자형에 따른 과배란 유도에서의 난소 반응은 통계적으로 의미있는 차이를 나타내지 않았다. 그러나 각각의 유전자형에 따라 난소 반응과 임상 결과가 다소 차이가 나타남을 확인할 수 있었으며, 이에 대한 추가적인 연구가 필요할 것으로 생각된다.

Objective: The purposes of this study were to determine the distribution of follicle-stimulating hormone receptor (FSHR) genotypes in infertile Korean women and to evaluate the relationship between FSHR genotypes and clinical outcomes of IVF-ET cycles. Methods: Genomic DNA was extracted from peripheral blood in 1, 020 of infertile Korean women. Genotypes of FSHR at Thr307Ala (T/A) and Asn680Ser (N/S) were screened by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Clinical outcomes related to the genotypes of FSHR were evaluated in IVF-ET cycles (n=302) with controlled ovarian hyperstimulation (COH) of infertile women under 40 years old. Results: In a population of 1, 020 infertile Korean women, the frequency of TT/NN, TA/NS and AA/SS for the major variant Thr307Ala and Asn680Ser was 44.80%, 41.96% and 10.49%, respectively. There was no significant difference in characteristics of ovarian response and clinical pregnancy rate among the major genotypes of FSHR in IVF-ET cycles with COH. However, implantation rate of AA/SS patients was significantly higher than that of TT/NN patients (24.5% vs 15.7%, p<0.05). Conclusion: This study showed that FSHR genotype was not directly associated with ovarian response in IVF-ET cycles with COH. The relationship between clinical outcomes and FSHR genotypes of patients should be substantiated by further studies.

키워드

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