IGF-1受体和雌激素受体在胚胎移植失败患者子宫内膜中的表达及其与子宫内膜容受性的关系

目的 探讨胰岛素样生长因子-1受体（IGF-1R）、雌激素受体（ER）在胚胎移植失败患者子宫内膜中的表达及其与子宫内膜容受性的关系。方法 选取2015年9月至2018年7月于首都医科大学附属北京妇产医院生殖中心就诊，且胚胎移植3次均失败的86例患者为研究对象（观察组），同时期选取首次冷冻胚胎移植获得临床妊娠的73例患者作为对照（对照组）。采用qRT-PCR法检测患者子宫内膜IGF-1R、ER mRNA表达水平；采用扫描电镜观察子宫内膜胞饮突发育状况，记录发育完全的胞饮突数目；采用Pearson法分析IGF-1R、ER与发育完全胞饮突数量的相关性。结果 两组促性腺激素（Gn）用量、Gn使用天数、基础卵泡刺激素（FSH）、获卵数、移植日内膜厚度、移植胚胎数目、移植优质胚胎数目、受精率比较，差异均无统计学意义（P>0.05）；观察组子宫内膜IGF-1R、ER mRNA水平低于对照组，差异有统计学意义（P<0.05）。对照组子宫内膜胞饮突发育完全例数较多，观察组胞饮突发育中/退化例数较多；观察组子宫内膜胞饮突完全发育数目低于对照组，差异均有统计学意义（P<0.05）。IGF-1R、ER与完全发育的胞饮突数量均呈正相关（r=0.699、0.650，P均<0.05）。结论 IGF-1R、ER表达水平与胚胎移植失败患者子宫内膜容受性有密切联系。

Expression of IGF-1 receptor and estrogen receptor in endometrium of patients with failed embryo transfer and its correlation with endometrial receptivity

Objective To explore the expression of insulin-like growth factor-1 receptor (IGF-1R) and estrogen receptor (ER) in the endometrium of patients who failed in embryo transferand the relationship between the two and endometrial receptivity. Methods From September 2015 to July 2018, 86 patients (observation group) who failed three times of embryo transfer in the Reproductive Center of Beijing Maternity Hospital Affiliated to Capital Medical University were recruited in the study. At the same time, 73 cases of clinical pregnancy obtained by the first frozen embryo transfer were selected as the control group. The expression levels of IGF-1R and ER mRNA in the endometrium of patients with repeated embryo transfer failure were detected by real-time fluorescent quantitative PCR (qRT-PCR);Scanning electron microscopy was used to observe the development of endometrial endocytosis and record the number of fully developed endocytosis;Pearson method was used to analyze the correlation between IGF-1R and ER levels and the number of fully developed endocytic processes. The relationship between IGF-1R and ER levels and endometrial receptivity was reflected to provide a simple index for clinical expression of endometrial receptivity.Results The endometrium IGF-1R and ER mRNA levels of observation group were lower than those of control group, and the difference was statistically significant (P<0.05); the endometrial endocytosis of control group was fully developed, and the observation group was mostly developing degeneration, and the difference between the two groups was statistically significant (P<0.05). The number of endometrial endocytic processes in observation group was significantly lower than that in control group (P<0.05); Pearson results showed that the levels of IGF-1R and ER mRNA were positively correlated with the number of fully developed endocytic processes (r=0.699, 0.650, P<0.05).Conclusions The expression levels of IGF-1R and ER may be closely related to endometrial receptivity in patients with failed embryo transfer.