促排卵周期PCOS妇女子宫内膜纤维粘连蛋白及层粘连蛋白的表达

目的:了解促排卵药物氯米酚(CC)、hMG及GnRH-a对黄体中期子宫内膜内膜纤维粘连 蛋白(FN)及层粘连蛋白(LN)表达的影响。方法:应用单克隆抗体,采用免疫组织化学技术检测50 例正常妇女自然周期以及50例正常妇女,45例多囊卵巢综合征妇女应用CC／hCG,CC／hMG／hCG 及GnRH-a／hMG／hCG方案促排卵治疗后黄体中期子宫内膜FN和LN的表达。结果:子宫内膜FN 和LN表达在正常妇女自然周期着床窗口时呈现强阳性;而CC、hMG抑制FN和LN的表达,使 其阳性强度减弱,有显著性统计学差异P<0．01;GnRH-a对FN和LN抑制不明显。同时妊娠者较 未妊娠者FN和LN表达强度高。结论:CC／hCG及CC／hMG／hCG方案促排卵后黄体中期子宫内膜 中FN和LN表达下降或缺失,内膜容受性下降,妊娠率降低。

Effect of Ovulation Induction on the Expression of Fibronectin and Laminin in Endometrium

Objective: To study the effect of clomephe citrite(CC), human menopausal gonadotropin (hMG) and gonadotropin releasing hormone analogue (GnRH-a) on the expression of fibronectin(FN) and laminin (LN) during implantation window in endometrium. Methods: Immunohistochemistry was performed on endometrium from midsecretory phase of 50 natural cycling in normal women, 45 PCOS women and 50 normal woman undergone treatment of CC hCG, CC hMG hCG and GnRH-a hMG induced ovulatory using monoclonal antibodies directed against FN and LN. Results: The expression of FN and LN were stronger in the endometrium of the natural cycles and GnRH-a hMG hCG cycle than induced ovulation cycles with CC hCG and CC hMG hCG, P<0.01. The expressions of FN and LN were stronger in pregnancy women than in those nonpregnancy women induced ovulation. Conclution: The endometrial receptivity and pregnancy rates were decline in the midluteal phase in normal women and PCOS women induced ovulation with CC hCG and CC hMG hCG. But in the cycle induced by GnRH-a/hMG/hCG, the receptivity is fine.