宫腔内人工授精中子宫内膜超声类型及厚度与妊娠的关系

目的：分析使用宫腔内人工授精患者中子宫内膜的类型及厚度与妊娠的关系。方法：分析189个治疗周期中具有三线征内膜,均质征内膜以及子宫内膜厚度＜8mm,≥8mm的妊娠结果。结果：189个治疗周期中,三线征子宫内膜为144个周期（76．2％）,妊娠率29．9％;均质征子宫内膜45个周期（23．8％）,妊娠率为26．7％。二者妊娠率差异无显著性（P＝0．680）。子宫内膜厚度≥8mm时,妊娠率明显提高（P＜0．01）。结论：宫腔内人工授精中,子宫内膜厚度＜8mm时,妊娠率明显降低。     

PCNA含量及DNA含量联合检测在子宫内膜癌及癌前病变中诊断意义

目的：说明ＰＣＮＡ含量及ＤＮＡ含量联合检测在子宫内膜癌及癌前病变中的诊断意义;两种取材方法对结果的影响,以探讨临床工作采用新鲜标本作为早期诊断的辅助手段是可行的。     

宫内节育器与兔子宫内膜生成内皮素的研究

自制金属单环放入兔左侧子宫角腔内,有明显抗生育效果,此为动物模型。选10只成年雌兔分为二组,将节育环放入每只兔左侧子宫角腔内,右侧为对照。一个月,三个月取子宫内膜,进行形态学观察,内皮素免疫组化定位及内膜组织中内皮素含量的测定。结果显示:内膜形态无明显改变,只在少数局部淋巴细胞略多。内皮素免疫组化定位显示左侧子宫角阳性反应比右侧强,一个月和三个月结果相似。放射免疫测定的内膜组织中内皮素含量左侧明显高于右侧。揭示金属单环引起内膜组织生成内皮素增加。     

Signals and molecular pathways involved in apoptosis, with special emphasis on human endometrium

Apoptosis is a selective process for deletion of cells in variousbiological systems. This event, similar to proliferation, istightly regulated, with both processes playing essential rolesin the homeostasis of renewable tissues. In human endometrium,proliferation and apoptosis occur at opposing poles of the menstrualcycle. The proliferative phase is marked by rapid growth ofthe endometrial epithelial lining, whereas progressive increasein apoptosis in this tissue is the hallmark of the secretoryand menstrual phases. The purpose of this review is to highlightsome of the signals and molecular events which are associatedwith and that may participate in apoptosis. This is followedby a review of the current literature regarding apoptosis inhuman endometrium.     

Turner's syndrome and pregnancies after oocyte donation

A total of 20 clinical pregnancies was achieved among 18 women with Turner's syndrome who were treated in an oocyte donation programme. The oocytes were donated by voluntary unpaid donors. A mean of 1.8 embryos per transfer was given to each recipient by way of 28 fresh and 25 frozen embryo transfers. With fresh and frozen embryos, 13 and seven pregnancies respectively were achieved. The clinical pregnancy rate per fresh embryo transfer was 46%, and the implantation rate 30%, being similar to the corresponding rates among our oocyte recipients with primary ovarian failure in general. The corresponding rates with frozen embryos were 28 and 19%. Of these pregnancies, 40% ended in miscarriage. This high rate may be explained by uterine factors. Six women were hypertensive during pregnancy, a rate comparable with that in other oocyte donation pregnancies. All these women delivered by Caesarean section. Pregnancy and implantation rates after oocyte donation were high in women with Turner's syndrome, but the risk of cardiovascular and other complications is high. Careful assessment before and during follow-up of pregnancy are important. Transfer of only one embryo at a time to avoid the additional complications caused by twin pregnancy is recommended.     

The relationships between endometrial thickness, and blood flow and pregnancy rates in in-vitro fertilization

To establish whether endometrial blood flow and thickness can predict the success rate of in-vitro fertilization, 156 cycles were evaluated. The parameters were: endometrial colour and power Doppler pulsatility index (PI), resistance index (RI), systolic/diastolic ratio (S/D) and endometrial thickness. Each patient was studied: on the day of ovum retrievalpickup, and on the day of embryo transfer. Non-endometrial parameters studied were: age, oestrestrogen and progesterone concentrations, number of oocytes, and number of embryos. Pregnancy was achieved in 31 cycles. On the day of ovum retrieval, patients who conceived had PI, RI, and S/D values of 0.997, 0.563, and 2.403, respectively. Patients who did not conceive had values of 0.994, 0.584, and 2.477 respectively. The power Doppler technique provided similar results. On the day of embryo transfer, pregnant patients had PI, RI and S/D values of 1.096, 0.590 and, 2.597 respectively, while in the non-pregnant patients the values were 1.104, 0.603 and, 2.723 respectively. Power Doppler showed similar numbers. The differences between pregnant and non-pregnant patients were not statistically significant in any of the parameters. Endometrial thickness and blood flow does not seem to correlate with pregnancy rate in IVF.     

Immunohistochemical localization of receptors for progesterone and oestradiol-17 beta in the implantation site of the rhesus monkey

The aim of the present study was to examine the cellular basis of the involvement of oestradiol and progesterone in blastocyst implantation in the primate. To this end, the cellular distribution of receptors for oestradiol (ER) and progesterone (PR) in fetal trophoblast cells and in endometrial compartments of timed lacunar (pre-villous) and villous stages of placentation in primary implantation sites collected on days 13-22 of gestation were investigated in rhesus monkeys. Both in pre-villous stage tissue and in villous stage tissue, cytotrophoblast cells and syncytiotrophoblast cells and other trophoblast derived cells were PR positive, while they were generally ER negative. Maternal endometrial cells were ER negative, while epithelial cells, stromal cells and vascular endothelial cells in maternal endometrium showed heterogeneous staining patterns for PR depending on their relative location; these patterns, however, correlated well with glandular hyperplasia and differentiation, stromal-decidual transformation and vascular response seen during blastocyst implantation.     

The effect of etonogestrel on VEGF, oestrogen and progesterone receptor immunoreactivity and endothelial cell number in human endometrium

Contraceptive use often leads to disrupted endometrial bleeding patterns in women. In this study, two different contraceptive regimes (Mircette, a monophasic oral contraceptive and Implanon, a long-acting gestagen) were used and their effects on the immunoreactivity of vascular endothelial growth factor (VEGF), oestrogen receptor (ER), progesterone receptor (PR) and endothelial cell number were determined. During the untreated normal cycle, there was a significant increase (P = 0.005) in glandular VEGF immunoreactivity and a significant decrease (P < 0.05) in PR immunoreactivity in the mid- and late secretory phases compared with the proliferative phase. There was a significant positive correlation (gamma = 0.38, P = 0.046) between stromal VEGF immunoreactivity and endothelial cell number. This correlation was also apparent during treatment with Implanon, but not with Mircette. Disrupted bleeding patterns were associated with Implanon and, to a lesser extent, with Mircette. Both contraceptives significantly reduced glandular VEGF immunoreactivity. Implanon significantly increased (P = 0.016) glandular PR staining, but Mircette significantly reduced (P = 0.027) stromal PR staining when compared with secretory before-treatment biopsies. There were no changes in endothelial cell number or glandular or stromal ER during the normal cycle, or with use of either contraceptive. There was no association between the parameters measured with bleeding patterns and histological category.     

胎盘催乳素在米非司酮抗早孕流产后刮出物组织中的分布

对米非司酮抗早孕流产后子宫出血的３０ 例患者的刮出内膜组织,用免疫细胞化学方法显示胎盘催乳素（ｈＰＬ） 。结果：刮出组织含有正常子宫内膜组织、残留蜕膜组织和少量绒毛膜绒毛。ｈＰＬ 阳性物质分布于残留绒毛滋养层细胞、子宫内膜和蜕膜中的滋养层碎片及滋养层细胞芽,在残留蜕膜组织中还可见很多ｈＰＬ 阳性细胞（ 绒毛外滋养层细胞） 。药流后刮出组织ｈＰＬ 阳性细胞的显示有助于及时发现侵入母体组织细胞的增生和癌变。     

人子宫内膜细胞共培养体系对早期鼠胚体外发育的影响

目的:研究人子宫内膜共培养体系对早期鼠胚体外发育的影响及移植后的妊娠情况。方法:将2-细胞小鼠胚胎与人子宫内膜细胞进行体外共培养,对照组为无营养细胞的单纯培养液,每日在显微镜下观察胚胎的发育情况。将培养到囊胚期的胚胎移植回小鼠的子宫腔,观察着床情况。结果:共培养体系中68.3％的2-细胞胚胎发育至桑椹胚期,50.8％发育至囊胚期,囊胚的孵化率为36.7％,胚胎的着床率为25.0％。而对照组只有24.8％的2-细胞胚胎发育至桑椹胚期,11.4％到达囊胚期,且其中大部分为早期囊胚即停止发育。另外对照组细胞碎片出现早且多,卵裂球不均匀,胚形态差,移植后胚胎的着床率仅为3.1％。结论:人子宫内膜细胞共培养体系可以促进小鼠胚胎的体外发育,改善胚胎的质量,提高着床率。