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Publico-00235.pdf: 311178 bytes, checksum: 4bdcda98426ffee2492755dd8ae27d33 (MD5) / Verificar a relacao entre as concentracoes de substancias reativas ao acido tiobarbiturico, a atividade das enzimas glutationa peroxidase e catalase com a ocorrencia de gravidez, com o estimulo hormonal administrado e com a presenca ou nao de um fator de infertilidade feminino. Metodo: Foi realizado um estudo prospectivo caso controle com o liquido folicular de 146 pacientes que foram submetidas ao programa de Reproducao Assistida da UNIFESP. Como criterios de inclusao foram considerados apenas as pacientes que realizaram o protocolo de fertilizacao in vitro (FIV) atraves de injecao intracitoplasmatica de espermatozoide (ICSI). Os grupos experimentais foram subdivididos de acordo com a presenca ou nao de gestacao, com hormonio administrado durante o estimulo (FSH ou FSH e hMG) e com a presenca ou nao de pelo menos um fator de infertilidade feminina. As aliquotas dos liquidos foliculares foram coletadas apos a retirada dos oocitos e analisadas por espectrofotometro para mensurar as concentracoes de substancias reativas ao acido tiobarbiturico (TBARS) . um marcador de peroxidacao lipidica, e das enzimas catalase e glutationa peroxidase presentes em cada amostra. Um modelo de regressao logistica foi construido utilizando numero de embrioes de alta qualidade no terceiro dia de cultivo transferidos, presenca de pelo menos um fator de infertilidade feminino e a atividade da glutationa peroxidase, maximizando a preditibilidade da ocorrencia de gravidez. Resultados: No grupo de mulheres nao gravidas foi observada uma maior atividade da enzima glutationa peroxidase (p=0,04). Nos outros grupos nao foi observada diferenca estatistica entre nenhum dos parametros avaliados. Na regressao logistica, o melhor modelo preditivo para gravidez incluiu os valores de fator de infertilidade, classificacao embrionaria no terceiro dia de cultivo e a atividade de glutationa peroxidase (73,68%, p=0.00001). O valor de odds-ratio para a atividade de glutationa peroxidase foi 0,98, indicando que valores crescentes de atividade glutationa levaram a diminuicao da chance de ocorrencia de gravidez. Conclusao: Nas condicoes deste estudo, (i) mulheres com ƒÀ-hCG negativo possuem uma maior atividade da glutationa peroxidase, (ii) diferentes estimulos ovarianos nao provocam alteracao nas concentracoes de TBARS e na atividade das enzimas antioxidantes e (iii) a presenca de pelo menos um fator de infertilidade feminino nao altera a concentracao de TBARS e a atividade da enzimas antioxidantes. / Objective: to verify the relation between thiobarbituric acid reactive substances concentrations, glutathione peroxidase and catalase activities, and occurrence of pregnancy, hormonal stimulation protocol utilized, and presence or not of a female infertility factor. Method: a prospective case-control study was carried with follicular fluid from 146 patients submitted to the Assisted Reproduction program at the Sao Paulo Federal University. Only patients submitted to in vitro fertilization (FIV) through intracytoplasmic sperm injection (ICSI) were included. The experimental groups were subdivided according to presence or absence of pregnancy, hormonal stimulation protocol used (FSH or FSH and hMG) and presence or absence of at least one female infertility factor. An aliquot of follicular fluid was collected after retrieval of the oocyte for analysis of thiobarbituric acid reactive substances concentrations, and glutathione peroxidase and catalase activities. All these analyses were carried out using a spectrophotometer. Groups were compared using Student’s T-test. A logistic regression model were calculated using embryo quality on day 3, presence or not of a female infertility factor, thiobarbituric acid reactive substances levels, and glutathione peroxidase (GPX) and catalase activities as independent variables, occurrence of pregnancy as a binary dependent variable. Results: Patients who did not achieve pregnancy presented higher glutathione peroxidase activity levels, when compared with patients who achieved pregnancy (p=0,04). In the other groups, no differences were observed. Logistic regression produced a model which best predicted pregnancy including presence of female infertility factor, embryo quality on day 3 and GPX activity (73.7% total predictive value, p=0.00001). Odds-ratio for GPX activity was 0.98, indicating that increasing values of GPX activity decreased the odds of occurrence of pregnancy. Conclusion: Based on our results, we may conclude that (i) higher GPX activity is associated to negative outcomes in ICSI cycles, (ii) different ovarian stimulation protocols does not alter concentrations of TBARS and activity of antioxidant enzymes, and (iii) the presence of at least one female infertility factor does not alter TBARS levels or antioxidant activity. / TEDE / BV UNIFESP: Teses e dissertações
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.unifesp.br:11600/9835 |
| Date | 25 March 2009 |
| Creators | Victorino, Amanda Begatti [UNIFESP] |
| Contributors | Universidade Federal de São Paulo (UNIFESP), Bertolla, Ricardo Pimenta [UNIFESP] |
| Publisher | Universidade Federal de São Paulo (UNIFESP) |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | Portuguese |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | 62 p. |
| Source | reponame:Repositório Institucional da UNIFESP, instname:Universidade Federal de São Paulo, instacron:UNIFESP |
| Rights | info:eu-repo/semantics/openAccess |
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