促排卵治疗对黄体中期子宫内膜雌、孕激素受体及其mRNA表达的影响

目的 :了解促排卵治疗对黄体中期子宫内膜雌激素受体 (estrogenreceptor,ER)、孕激素受体 (progesteronereceptor,PR)及其mRNA表达的影响。方法 :应用光学显微镜检测着床窗口子宫内膜、采用免疫组化及原位杂交方法检测正常及多囊卵巢综合征 (polycysticovariansyndrome ,PCOS)妇女促排卵治疗后子宫内膜黄体中期ER、PR及其mRNA的表达 ,放射免疫法测定同期血中雌激素 (estradiol,E2 )及孕激素 (progesterone,P)水平。 结果 :正常妇女黄体中期子宫内膜组织形态 2 2例中有 2 0例为分泌中期改变 ,2例为分泌早期改变。ER、PR弱表达 ,ERmR NA及PRmRNA的表达也较弱 ,而PCOS妇女治疗后黄体中期氯米芬 9/人绒毛膜促性腺激素组及氯米芬 /绝经期促性腺激素 /人绒毛膜促性腺激素组各 15例分别有 8/ 15及 7/ 15光镜下为分泌中期改变 ,其它为分泌早期改变。ER、PR的表达增强 ,其基因的表达也明显增强 ,血清P的水平相对较低。促性腺激素释放激素激动剂 /绝经期促性腺激素 /人绒毛膜促性腺激素组共 10例 ,E2 、P及P/E2 接近对照组 ,上述标志物的表达与对照组相似。但 3组PCOS分泌中期子宫内膜均有不同程度的间质增生、致密 ,腺体与间质发育不同步 ,且间质致密处ER、PR及其mR NA表达均下降。结论 :氯米芬 /人绒毛膜促性腺

The effect of ovulation induction on the expression of estrogen and progesterone receptors and their mRNA in the midluteum endometrium

Objective: To study the effect of ovulation induction on the expressions of estrogen receptor, progesterone receptor and their mRNA in endometrium. Methods: Optical microscopic observation,immunnohistoche mical and in situ hybridization techniques were used to characterize endometrial changes of the expressions of ER, PR and their mRNA in the implantation windows with 22 healthy and 40 PCOS women post ovulation inductions. Sera P and E 2 of midluteal phase were measured by radioimmunol techniques. Results: In the control group,20 cases were found to be in mid secretory phase and 2 cases in early secretory phase. ER and PR expressions varied from (-)to (+), ER and PR mRNAs expressions were low. In CC/HMG/HCG and CC/HCG groups(15 PCOS patients each),mid secretory phase changes were found in nearly 50%, and the remainings had early secretory phase changes. Luteal phase was characterised by P secretion deficiency, supraphysiologic estradiol levels, decrease of P/E 2 ratio, and enhancement of ER,PR,ERmRNA and PRmRNA expressions. In GnRH a/HMG/HCG group (10 cases) all the parameters and markers described above were similar to those of the control group In all the PCOS groups, mid secretory phase of the endometrium preseat various degrees of the proliferation and density of stroma while the developments of the stroma and yands were not synchromistic. ER, PR expressions were decreased at dense stroma sites. Conclusion: CC/HCG and CC/HMG/HCG protocols induced an increase of E 2 levels, a decrease in P secretion and P/E 2 ratio during the secretary phase, thus affecting the endometrial receptivity. In GnRH a/HMG/HCG protocol E 2,P levels and P/E 2 ratio were similar to the control group, which is beneficial to the endometrial receptivity of the embryo.