原因不明性不孕患者子宫内膜基质金属蛋白酶-9 mRNA的表达及其性激素调节

目的　检测基质金属蛋白酶 9(MMP 9)及其抑制物 1 (TIMP 1 )mRNA在原因不明性不孕患者黄体中期子宫内膜中的表达 ,及与性激素的相关性。方法　采用原位杂交、逆转录聚合酶链反应(RT PCR)技术 ,对 38例原因不明不孕患者 (研究组 )和 2 0例正常生育期妇女志愿者或男方因素不孕患者 (对组照 )的黄体中期子宫内膜行MMP 9、TIMP 1mRNA检测 ,同期放射免疫法测定雌二醇 (E2 )、孕酮 (P)水平。结果　子宫内膜腺上皮、间质细胞胞浆、胞核均有MMP 9、TIMP 1mRNA的表达 ,研究组较对照组表达少 ,研究组黄体中期子宫内膜MMP 9mRNA表达水平为 0 .42± 0 .1 9,显著低于对照组的 0 .57± 0 .1 9(P <0 .0 5) ;研究组TIMP 1mRNA表达水平为 0 .59± 0 .1 9,显著低于对照组的 0 81± 0 .2 0 (P <0 .0 1 )。研究组黄体中期血清P水平为 (34± 1 5)nmol/L ,显著低于对照组的 (53± 1 7)nmol/L(P<0 .0 1 ) ,而血清E2 水平与对照组比较 ,差异无显著性 (P >0 .0 5)。对照组P水平与MMP 9mRNA表达呈正相关 (r=0 .72 2 ,P <0 .0 1 ) ,而研究组无相关性 (P >0 .0 5) ;两组P水平与TIMP 1mRNA ,E2 与MMP 9、TIMP 1mRNA均无相关性 (P >0 .0 5)。结论　原因不明不孕患者黄体中期P水平影响MMP 9、TIMP 1mRNA的表达并致活性下降 ,可能与不孕     

子宫内膜腺癌中TET2、5-hmC与ERα的表达及临床意义

目的:探究TET2、ERα及5-hmC在子宫内膜腺癌组织中的表达及临床意义。方法:选取88例子宫内膜腺癌、20例正常增殖期内膜患者的子宫内膜组织蜡块,免疫组化法检测TET2、ERα及5-hmC表达,采用Kaplan-Meier法以及Cox比例风险回归模型分析TET2、ERα及5-hmC表达水平与子宫内膜腺癌患者总生存期的关系。结果:子宫内膜腺癌组织中TET2、5-hmC和ERα表达水平显著低于正常增殖期内膜组织(P <0. 05)。ERa与5-hmC表达呈正相关(r=0. 692,P=0. 000),ERa与TET2表达呈正相关(r=0. 477,P=0. 000),5-hmC表达与TET2表达呈正相关(r=0. 331,P=0. 002)。KaplanMeier生存分析显示,TET2、5-hmC阴性表达患者的平均生存时间显著短于阳性表达患者(P<0. 01)。多因素Cox回归分析显示,TET2表达可作为子宫内膜腺癌患者预后的独立危险因素(HR=14. 520,95%CI为1. 060～198. 843,P=0. 045)。结论:子宫内膜腺癌组织中TET2、ERα蛋白表达水平降低且与5-hmC水平相关。TET2下调可能是子宫内膜腺癌的一个潜在预后指标。     

细胞周期调控相关蛋白P53、P16、P21、Rb在子宫内膜癌的表达与意义

目的 :研究与细胞周期G1→S调控点相关的P5 3、P16、P2 1、Rb蛋白在子宫内膜癌的表达及其相关情况 ,探讨其临床应用价值。方法 :采用免疫组化 (LSAB法 )检测上述指标在 2 1例正常子宫内膜、15例子宫内膜上皮内瘤样病变 (EIN)及 4 5例子宫内膜癌中的表达。结果 :P5 3蛋白表达由正常内膜、EIN至内膜癌逐渐升高 ,而P16、P2 1、Rb蛋白结果相反 ;在子宫内膜癌中 ,P5 2和P2 1呈负相关 (r =- 0 .32 2 ) ,P16、P2 1与Rb呈正相关 (r=0 .36 1;r =0 .4 41)。P2 1蛋白表达与良好病理学分级有关 (P <0 .0 5 ) ,P5 3蛋白表达与临床各参数有关 ,与ER、PR的表达呈负相关 ,单因素及多因素分析均提示P5 3蛋白表达阳性的子宫内膜癌患者预后差 (P <0 .0 5 )。结论 :与细胞周期G1→S调控相关的P5 3、P16、P2 1、Rb蛋白均参与子宫内膜癌发生、发展 ,且部分基因相互关联 ,P5 3可作为独立预后因素应用于临床 ,其阳性表达提示预后不良     

不孕女性的生育和心理压力对子宫内膜及内膜下血流的影响

目的:探讨不孕女性的生育和心理压力与子宫内膜及内膜下血流的相关关系。方法:采用生育压力(FPI)、心理压力(SRQ)、特质应对问卷(CSQ)、生活事件量表(LES)对115例初诊的不孕女性进行生育和心理压力测评。同时,采用三维能量多普勒超声测量子宫内膜及内膜下容积、血管化指数(VI)、血流指数(FI)及血管化血流指数(VFI)。结果:FPI总分与子宫内膜及内膜下血流的FI显著相关(r1=-0.248,r2=-0.290,P0.05);积极应对与子宫内膜及内膜下血流的FI具有相关性(r3=0.210,r4=0.242,P0.05);生活事件与子宫内膜下VFI具有相关性(r5=-0.191,P0.05);且FPI的相关系数大于心理压力的相关系数。结论:FPI和积极应对与子宫内膜及内膜下血流的FI存在相关性,要重点关注不孕女性的生育压力。     

氯米芬合用阿司匹林对子宫内膜发育和子宫血流的影响

目的:观察小剂量阿司匹林是否能改变氯米芬诱导排卵后子宫内膜的厚度、改善子宫血流的灌注。方法:4 5例不明原因不育或男方因素不育的妇女平均分为自然周期组、氯米芬组(CC组)、氯米芬加阿司匹林组(CC加aspirin组) ,观察3组HCG日及HCG加9天的激素水平、子宫内膜厚度、子宫动脉搏动指数(PI) ,HCG日的子宫内膜类型。结果:CC组无论HCG日还是HCG加9天内膜厚度均明显小于自然周期组(P <0 .0 5 ) ,而CC加aspirin组内膜厚度均明显大于CC组(P <0 . 0 5 )。CC组无论HCG日还是HCG加9天的子宫动脉搏动指数(PI)均明显著大于自然周期组(P <0 . 0 5 ) ,而CC加aspirin组子宫动脉搏动指数(PI)均显著小于CC组(P <0 . 0 5 )。结论:小剂量阿司匹林能改善氯米芬诱导排卵中的子宫血流灌注,从而改善子宫内膜发育。     

胎儿生长受限孕妇血清皮质醇浓度与胎盘组织IGF-1表达水平研究

目的:探讨胎儿生长受限(FGR)孕妇血清皮质醇浓度与胎盘组织胰岛素样生长因子- 1(IGF - 1)表达水平间的关系及两者在FGR发生中的作用。方法:利用放射免疫法测定血清皮质醇浓度;利用Brown法测定尿雌激素/肌酐(E/C)比值;利用免疫组织化学方法及多媒体彩色病理图像分析技术测定胎盘组织IGF - 1表达水平。结果:FGR组血清皮质醇浓度明显高于对照组(P <0 .0 5 ) ,血清皮质醇浓度与胎儿体重、胎盘重量及胎盘功能呈负相关(r=- 0 .388,P <0 .0 5 ;r=- 0 .36 9,P <0 .0 5 ;r=- 0 .32 9,P <0 .0 5 ) ;FGR组胎盘组织IGF - 1表达水平低于对照组(P<0 .0 5 ) ,且与胎儿重量、胎盘重量及胎盘功能呈正相关(r =0 .6 49,P <0 .0 1;r =0 .4 44,P <0 .0 5 ;r=0 .6 0 6 ,P <0 .0 1) ;血清皮质醇浓度与胎盘组织IGF - 1表达水平呈负相关(r =- 0 .385P <0 .0 5 )。结论:孕妇血清皮质醇浓度升高及胎盘组织IGF - 1表达水平下降可能是FGR的致病原因之一,血清皮质醇可能通过影响胎盘组织IGF - 1表达水平而导致FGR。     

不孕症子宫内膜息肉雌激素受体和孕激素受体表达的研究

目的:探讨不孕妇女子宫内膜息肉中雌激素受体(ER)和孕激素受体(PR)的表达及意义。方法:选择2009年9月至2010年4月在广东省计划生育专科医院就诊伴发子宫内膜息肉的50例不孕妇女(EP组)作为研究组,同期就诊宫腔镜检查正常的29例不孕妇女作为对照组。采用免疫组化方法测定ER和PR在子宫内膜息肉和正常增殖期子宫内膜中的表达,同时采用化学发光法测定所有患者血清的基础性激素(血清卵泡刺激素、黄体生成素、催乳素、雌二醇和睾酮)水平,并对两组的基本情况(年龄、不孕类型、不孕原因、不孕年限及取材时间)进行比较。结果:两组基础性激素水平和基本情况的比较中,仅EP组血清雌二醇水平显著高于对照组(223.39±125.47pmol/Lvs169.96±87.46pmol/L,P=0.046),其他各项指标的比较,差异均无统计学意义(P>0.05)。ER和PR在子宫内膜息肉和增殖期子宫内膜中的表达比较,差异均无统计学意义(P=0.085,P=0.527)。结论:对于无月经改变的不孕症子宫内膜息肉,长期较高水平的雌二醇刺激可能与息肉形成有关,但子宫内膜息肉上ER、PR表达未见异常。     

子宫内膜异位症累及卵巢对未破裂黄素化卵泡发生频度的影响

子宫内膜异位症在生殖年龄妇女中的发病率高达10%,在女性不孕中,子宫内膜异位约占20%。未破裂卵泡黄素化(LUF)综合征指排卵期虽无排卵,但卵泡通过自行黄素化而出现黄体期相应改变的现象。现已发现在子宫内膜异位症不育患者中,LUF综合征的发生率明显增高,且与子宫内膜异位症病变程度相关。本文采取前瞻性分析方法,对126例22～55岁的不孕妇女施行诊断性腹腔镜检查。根据修订的美国生殖协会阶段评分标准进行分期。LUF的诊断标准为:连续B超监测无排卵征象,尽管血清孕酮水平升高,但黄体期行腹腔镜检未见排卵裂孔。本研究的目的在于评估不孕的…     

p16和CDK4在子宫内膜腺癌中的表达及其临床意义

目的 :探讨p16和细胞周期素依赖性激酶 4 (cyclindependentkinase 4 ,CDK4 )在子宫内膜腺癌中的表达及其临床意义。方法 :采用免疫组化SP法检测 32例子宫内膜腺癌中p16和CDK4蛋白的表达。结果 :32例子宫内膜腺癌中p16蛋白表达阳性率为 4 3.8% ,p16阳性表达与子宫内膜腺癌的组织学分级、肌层浸润深度和淋巴结转移呈负相关 (P <0 .0 5 ) ,但和临床分期无关 (P >0 .0 5 )。CDK4在子宫内膜腺癌中的阳性表达率为 68.8%(2 2 /32 ) ,CDK4阳性表达与子宫内膜腺癌的浸润深度和淋巴结转移呈正相关 (P<0 .0 5 ) ,与组织学分级和临床分期无关 (P >0 .0 5 )。p16和CDK4的表达呈负相关 (P <0 .0 5 )。结论 :p16和CDK4作为细胞周期调控因子可能参与了子宫内膜腺癌的发生发展     

子宫内膜异位症患者术后不孕原因分析

目的 :分析子宫内膜异位症伴不孕患者腹腔镜术与开腹手术后仍然不孕的原因。方法 :选择 10 3例有手术指征的子宫内膜异位症伴不孕患者 ,分为腹腔镜与开腹手术两组进行手术治疗 ,术后口服孕三烯酮 3～ 6个月 ,随访患者 2年内妊娠情况 ,分析术后不孕的原因。结果 :子宫内膜异位症伴不孕患者腹腔镜术后 2年内妊娠率为 5 5 .2 0 % ,开腹手术 5 0 .0 0 % ,总妊娠率为5 2 .74 % ,两组妊娠率差异无显著性 (P >0 .0 5 ) ;子宫内膜异位症分期程度与输卵管通畅程度差异无显著性 (P >0 .0 5 )。术后不孕原因中 ,输卵管不通占 37.2 1% (16 / 4 3) ,子宫腺肌病 13.95 % (6 /4 3) ,子宫内膜异位症复发 9.30 % (4/ 4 3) ,子宫内膜异位症合并子宫肌瘤 6 .98% (3/ 4 3) ,既往有两次开腹史者 4 .6 5 % (2 / 4 3)。另外还有 2 7.91% (12 / 4 3)输卵管通畅但不孕原因未明。结论 :治疗子宫内膜异位症伴不孕应选手术治疗 ,有条件首选腹腔镜手术 ;术后不孕与输卵管不通关系密切 ,子宫内膜异位症合并子宫肌瘤及腺肌病等也是不孕的原因。     

Endometrial Evaluation Is Not Predictive for In Vitro Fertilization Treatment

Purpose: The main purpose of this study was to evaluate ovarian function by clomiphene citrate (CC) challenge test in a group of tubal infertile women and to study endometrial morphological maturation in the early luteal phase of CC-stimulated cycles as compared to in vitro fertilization (IVF) treatment outcome. Methods and Results: Four women presented with strongly retarded, proliferative endometrium in the luteal phase. Of these, three presented with impaired ovarian function, high basal follicle-stimulating hormone, and high follicle-stimulating hormone levels after clomiphene stimulation on cycle day 10. In the remaining 30 women, showing an in-phase endometrium after CC stimulation, a comparison of six morphological characteristics did not reveal any significant differences between the 14 women who did become pregnant and the 16 who did not. No significant differences in endometrial thickness were observed between the groups. Significant differences were found when comparing estradiol and progesterone area under the curve during the luteal phase (P < 0.001 and P < 0.01, respectively) between those who did and those who did not become pregnant. Conclusions: Luteal endometrium morphology was not a sharp instrument to detect differences between women who did and women who did not become pregnant following IVF treatment, while ovarian function, as measured by hormonal markers, seemed to be a more reliable prognostic factor for IVF treatment outcome.     

不明原因不孕患者着床窗期子宫内膜形态结构与性激素及其受体表达

目的:研究着床窗期子宫内膜形态结构与性激素及其受体表达判断不明原因不孕患者的子宫内膜条件及黄体功能。方法:活检不明原因不孕55例及正常生育16例着床窗期子宫内膜行组织学天数及组织学分型;内膜扫描电镜观察胞饮突。检测黄体功能缺陷8例及子宫内膜反应不良6例着床窗期内膜性激素及其受体。结果:不孕组内膜的发育同步率(63.6%)明显低于正常生育组(93.8%),差异有统计学意义(P<0.05)。不孕组子宫内膜胞饮突数量少,且发育明显滞后于正常生育组。黄体功能缺陷患者着床窗期子宫内膜孕激素受体表达与正常生育组无统计学差异(P>0.05);子宫内膜反应不良患者孕激素受体表达明显低于正常生育组,差异有统计学意义(P<0.05)。结论:着床窗期子宫内膜发育同步性差,内膜容受性欠佳可能是部分不明原因不孕的病因之一。鉴别由黄体功能缺陷抑或子宫内膜反应不良引起的分泌期子宫内膜发育不良,是临床选择治疗方案的关键。     

薄型子宫内膜合并甲状腺功能减退不孕患者的辅助生育治疗结局

目的探讨薄型子宫内膜合并甲状腺功能减退不孕患者行辅助生育治疗后的效果。方法 165例因新鲜周期内膜≤7 mm而取消胚胎移植的不孕患者,在拟行冻融胚胎移植前,对游离甲状腺素T4(FT4)正常、促甲状腺激素(TSH)2.5 mIU/L的患者进行左旋甲状腺素片干预治疗。经治疗4~8周后,患者依据TSH水平分为A组(n=70),TSH2.5 mIU/L;B组(n=95),TSH≤2.5 mIU/L。所有患者均采用相同剂量激素替代方案准备子宫内膜,分析子宫内膜情况及辅助生育结局。结果 A组与B组相比,虽然子宫内膜下血流数量和阻力指数(RI)组间无统计学差异(P0.05),但B组内膜下血流数量的均值高于A组,RI均值低于A组。且B组的子宫内膜厚度、临床妊娠率显著高于A组(P0.05),流产率显著低于A组(P0.05)。结论薄型子宫内膜合并TSH升高的不孕患者,给予干预至TSH2.5 mIU/L后,行辅助生育治疗可改善这些患者的妊娠结局。     

Physiopathological aspects of corpus luteum defect in infertile patients with mild/minimal endometriosis

Purpose: We describe a physiopathological model to the luteal insufficiency of infertile patients with mild/minimal endometriosis with normal hormone measurements in the early follicular phase. Methods: We designed a case-control study with 24 patients, 14 fertile with in-phase endometrium (control group) and 10 infertile with mild/minimal endometriosis and luteal insufficiency (study group). The histologic dating of endometrium was performed during cycle days 23–25 and serum TSH, FSH, LH, prolactin, and estradiol levels were measured during the early follicular phase (cycle day 3). Progesterone serum levels were measured in three different occasions during the luteal phase. Results: Patients with out-of-phase endometrium have lower estradiol levels (P = 0.031) and decreased progesterone secretion (P = 0.012) during the late luteal phase. Serum prolactin, TSH, FSH, and LH levels were similar between the groups (P > 0.05). Conclusions: The physiopathology of luteal phase defect in infertile patients with mild/minimal endometriosis is associated with a small and large luteal cells dysfunction, characterized by abnormal follicular phase (lower estradiol serum levels) and lower progesterone LH-dependent secretion.     

Lipid peroxidation, antioxidant defense, status of trace metals and leptin levels in preeclampsia

OBJECTIVE: To investigate the changes in enzyme activities of erythrocyte superoxide dismutase (SOD), catalase, and placental glutathione peroxidase (GSH-Px), and analyze the levels of serum malondialdehyde (MDA), copper (Cu), zinc (Zn), selenium (Se), leptin and placental MDA and glutathione (GSH). STUDY DESIGN: Cross-sectional prospective study consisting of 32 preeclamptic (PE) pregnant, 25 non-pregnant (NP) women, 28 healthy pregnant (HP) women. Levels of lipid peroxides in serum and placenta, and activities of SOD, catalase in erythrocyte and placental GSH level, placental GSH-Px activity were measured by spectrophotometric methods. Serum levels of Cu, Zn, Se measured by atomic absorption spectrophotometry. Serum levels of leptin was measured by enzyme immunoassay by using the Cayman chemical kit. One-way analysis of variance and post hoc Tukey-HSD test and Pearson correlation test were used for the statistical analyses. RESULTS: Serum levels of MDA, Cu, Leptin were markedly higher (P < 0.001); and serum level of Se was markedly lower (P < 0.001) in PE women compared with HP women and NP women. Also, placental MDA level was higher (P < 0.001) and placental GSH-Px activity was lower in PE women compared with HP women. In preeclamptic women erythrocyte catalase activity was markedly increased (P < 0.001), while erythrocyte SOD activity was markedly decreased (P < 0.001) compared to HP women and NP women. Placental GSH level was decreased compared to HP women (P < 0.001). Serum level of Zn was markedly decreased compared to NP women (P < 0.001) but no significant difference was observed in PE pregnant when compared with HP women (P > 0.05). Placental MDA level in PE women had significant negative correlation with serum Se level (r = -0.353, P < 0.05). A negative correlation was found between erythrocyte catalase activity with birth weight (r = -0.528, P < 0.001). Also, there were a significant negative correlation between serum levels of Cu and Se in the preeclamptic women (r = -0.407, P < 0.05). CONCLUSION: Our data demonstrate that elevation of lipid peroxides together with impaired antioxidant defense mechanisms and status of trace metals and the presence of possible interrelationship and crosstalk between those parameters may be related at least partly to the pathogenesis of preeclampsia. Additionally, lipid peroxides and blood oxidative imbalance could be part of the cytotoxic mechanisms leading to endothelial cell injury.     

Ultrasonographic changes in the endometrium during ovulatory cycles--correlation to serum estradiol and progesterone concentrations

Daily changes in the thickness and texture of the endometrium were assessed by ultrasonography in 15 natural ovulatory cycles. The endometrium in the follicular phase became thicker every day until ovulation [5.8 +/- 1.8 mm (mean +/- SD) on day -8, 10.7 +/- 2.9 mm on day 0, day 0: ovulation], but the thickness did not change during the luteal phase. There was a significant correlation between the thickness of the endometrium and the serum estradiol concentration in the follicular phase (r = 0.64, n = 89, p less than 0.01), but the change in the thickness of the endometrium varied with the individual. The texture of the endometrium changed in the menstrual cycle. The hyperechoic area of the endometrium spread from the basal layer to the lumen during the early-mid luteal phase. The ratio of the thickness of the hyperechoic area to the total thickness of the endometrium (hyperechoic endometrial area ratio, HEA ratio) increased from 34.3 +/- 11.0% on day 0 to 100% on day 9. There was a significant correlation between the HEA ratio and the serum progesterone concentration in the period from day -2 to day 9 (r = 0.68, n = 91, p less than 0.01).     

Serum progesterone levels in women treated with human menopausal gonadotropin and human chorionic gonadotropin for in vitro fertilization

For evaluation of the adequacy of luteal function after in vitro fertilization-embryo transfer (IVF-ET), serum progesterone (P) levels were measured on days 3, 7, and 10 after laparoscopic follicle aspiration. Fifty-six infertile patients were treated during 86 cycles with human menopausal gonadotropin-human chorionic gonadotropin (hMG-hCG) for stimulation of follicular development. Serum estradiol (E2) levels were measured daily during hMG-hCG treatment. P levels were determined in 67 cycles. The mean (+/- standard deviation [SD]) of the sums of 3 P levels was 55.63 +/- 24.13 ng/ml. There were 11 pregnancies. The mean of the sums of 3 P levels of pregnant patients was 64.45 +/- 26.23 ng/ml and of 56 nonpregnant cycles was 53.90 +/- 23.35 ng/ml. The duration of luteal phase varied from 9 days to 15 days. The mean of the sums of 3 P values of patients with different luteal phase lengths ranged from 28.8 ng/ml to 60.51 +/- 25.68 ng/ml. The mean of the sums of 3 P levels of women with normal luteal phase and that of women with luteal phase defect by endometrial biopsy study were used as controls for comparison. There was poor correlation (r = 0.3441) between E2 peak levels and P levels; the sum of 3 P levels did not indicate luteal phase inadequacy in IVF-ET patients; and the majority of the nonpregnant cycles (32/56) showed a luteal phase of 11 days or less, in spite of adequate P levels.(ABSTRACT TRUNCATED AT 250 WORDS)     

Norplant users with irregular bleeding. Ultrasonographic assessment and evaluation of serum concentrations of estradiol and progesterone

OBJECTIVE: To determine the changes in thickness and pattern of endometrium among Norplant (Leiras, Leiras Oy, Turku, Finland) users who have irregular bleeding and to correlate these changes with estradiol and progestrone concentrations. STUDY DESIGN: Ultrasonographic evaluation (vaginal ultrasound) and serum sampling were performed on Norplant users who presented with complaints of bleeding at their first visit to the Family Planning Clinic, Department of Obstetrics and Gynecology, Chulalongkong Hospital, Bangkok, Thailand, between October 1, 1998, and March 31, 1999. RESULTS: A total of 85% (44/52 cases) of the subjects had estradiol concentrations < 50 pg/mL, and none had any luteal activity (progesterone concentration < 3 ng/mL). The endometrial thickness remained thin and very thin (3-6 mm = 50%, < 3 mm = 48%). A hyperechoic pattern in the endometrium was found in 90% of the subjects. There was a weak, negative correlation between estradiol concentration and endometrial thickness (P < .05, r = -.337). CONCLUSION: Norplant users with irregular bleeding were usually characterized by low estradiol concentrations, absence of luteal activity and a thin, hyperechoic pattern in the endometrium.     

Evaluation of a nonhomogeneous endometrial echo pattern in the midluteal phase as a potential factor associated with unexplained infertility

OBJECTIVE: To determine whether the failure to develop a homogeneous hyperechogenic pattern in the midluteal phase is associated with decreased fecundity in infertile women who are not receiving follicle-maturing drugs. DESIGN: Observational study. SETTING: Outpatient infertility clinic of a University Medical Center. PATIENT(S): Two hundred ninety-six infertile women (> or =6 months) with regular menses, normal fallopian tubes and uterine cavity, and absence of severe male factor on their initial investigation cycle for follicular dynamic studies. INTERVENTION(S): Midluteal phase sonographic endometrial evaluation. MAIN OUTCOME MEASURE(S): Viable pregnancy rates (live fetus at end of first trimester) according to endometrial echo pattern in the midluteal phase. Other variables considered were age of patient, endometrial thickness and serum E(2) levels at midcycle and midluteal phase, midcycle echo pattern, and P levels in the midluteal phase. RESULT(S): The viable pregnancy rate was significantly higher in those women who exhibited a homogeneous hyperechogenic pattern (8.5%) compared to those women whose endometrium was found to be nonhomogenous (2.2%). No other confounding variables were found that could explain this outcome. CONCLUSION(S): A nonhomogeneous hyperechogenic sonographic endometrial echo pattern predicts lower fertility potential in women who are not receiving follicle-maturing drugs.     

Placental protein 12 (PP12) in the human endometrium: tissue concentration in relation to histology and serum levels of PP12, progesterone and oestradiol

Placental protein 12 (PP12) was measured by radio-immuno-assay in serum and endometrial extracts of 25 women at various phases of the menstrual cycle, and in the decidua from six women undergoing legal abortion in early pregnancy. The results were analysed with respect to endometrial histology and serum oestradiol, progesterone and PP12 concentrations. PP12 was detected in the secretory phase endometrium and decidua, but not in the proliferative phase endometrium. The PP12 concentration in tissue increased from early (1.3-9.4 micrograms/g protein) to late secretory phase (5.3-155 micrograms/g), and considerably higher levels were found in decidua (282-3846 micrograms/g). There was a correlation (P less than 0.001) between endometrial PP12 and serum progesterone levels in non-pregnant women, and there also was a slight correlation (P less than 0.05) between endometrial and serum PP12 concentrations. These results show that PP12 is not pregnancy specific and suggest that the occurrence of PP12 is dependent on progesterone.