摘要
目的通过观察体外受精-胚胎移植患者接受子宫内膜微刺激术后对胞饮突、白血病抑制因子和骨桥蛋白的影响,研究子宫内膜微刺激对子宫内膜容受性的影响。方法在我院接受IVF-ET新鲜周期移植的不孕患者120例,分为微刺激组68例和非微刺激组52例。微刺激组在胚胎移植前一个月经周期的第3～5天对子宫内膜进行浅表机械性搔刮,非微刺激组则未进行浅表机械性刺激,同一个月经周期的黄体期两组患者均进行内膜活检。对两组患者进行临床分析,电镜下观察两组胞饮突变化,免疫组织化学技术检测子宫内膜LIF和OPN蛋白表达。结果两组患者临床特征、控制性超促排卵(COH)情况比较,差异无统计学意义(P>0.05);微刺激组与非微刺激组胚胎着床率和临床妊娠率比较,差异具有统计学意义(P<0.05);微刺激组胞饮突表达较非微刺激组更为丰富,差异具有统计学意义(P<0.05),微刺激后LIF、OPN在胞质中棕褐色染色颗粒遍布更多,染色加深,呈高表达。结论子宫内膜微刺激可以改变胞饮突的丰富度,提高子宫内膜容受性的标志性细胞因子LIF、OPN蛋白水平的表达,提高患者胚胎着床率和临床妊娠率。
Objective To observe the effect of endometrial scratch on pinopodes,leukemia inhibitory factor and osteopontin in vitro fertilization-embryo transfer patients,study the effect of endometrial scratch on endometrial receptivity.Methods Selected 120 infertile patients who underwent IVF-ET fresh-cycle transplantation in our hospital,including 68 patients in the scratch group and 52 patients in the non-scratch group.In the scratch group,superficial mechanical scratch was performed on the endometrium on the 3rd to 5th day of the embryonic cycle before the embryo transfer.Non-scratch group did not perform superficial mechanical scratch.Intimal biopsy was performed in both groups of patients during the luteal phase of the same menstrual cycle.Patients in the two groups were clinically analyzed.Electron microscopy was used to observe the pinopodes.Immunohistochemical technique was used to detect the protein expression of LIF and OPN in endometrium.Results There were no significant differences in clinical features and controlled ovarian hyperstimulation between the two groups(P>0.05).The embryo implantation rate and clinical pregnancy rate of patients in the scratch group were higher than in the non-scratch group,the differences were statistically significan(t P<0.05).The expression of pinopodes in scratch group was more abundant than that in non-scratch g roup,t he d ifference w as s tatistically s ignifican(t P<0.05).After scratch,the expressions of LIF and OPN in the cytoplasm were more brown stained particles,and the staining was deepened and expressed highly.Conclusion Endometrial scratch can change the richness of pinopodes,increase the expression of endometrial receptivity marker cytokines LIF,OPN protein,and improve the implantation rate and clinical pregnancy rate of patients.
作者
巫珊
李丹
刘晶晶
李俊魁
马艳华
Wu Shan;Li Dan;Liu Jingjing(Department of Reproductive Medicine Center,No.254 Hospital of PLA,Tianjin 300142)
出处
《中国现代医药杂志》
2018年第10期8-12,共5页
Modern Medicine Journal of China
