3种内膜受体影响体外受精-胚胎移植结局的研究

目的:探讨在体外受精胚胎-移植(IVF-ET)和冻融胚胎移植(FET)过程中,患者子宫内膜受体表达及内膜组织形态学对胚胎着床前期子宫内膜容受性的影响。方法:选择接受助孕的不孕症患者80例为研究对象,于尿LH阳性的6～10天刮取子宫内膜组织,分别进行HE染色和免疫组织化学链霉素抗生物素蛋白-过氧化酶连接法(S-P)对子宫内膜雌激素受体(ER)、孕激素受体(PR)及表皮上皮生长因子受体(EGFR)染色强度和染色分布进行半定量分析。随访IVF-ET、FET结局,分为IVF-ET妊娠组18例,IVF-ET非妊娠组26例,FET妊娠组14例,FET非妊娠组22例。结果:IVF-ET妊娠组和FET妊娠组的ER、PR、EGFR均比IVF-ET非妊娠组、FET非妊娠组积分值高(P<0.05)。IVF-ET妊娠组、FET妊娠组的分泌期比率比IVF-ET非妊娠组、FET非妊娠组高,但各组间差异无统计学意义(P>0.05)。结论:子宫内膜ER、PR、EG-FR表达影响胚胎着床前期子宫内膜容受性,影响胚胎移植结局,可作为预测妊娠结局的指标。

Study on the effects of three kinds of endometrial receptors on outcome of in vitro fertilization and embryo transfer

Objective:To explore the effects of endometrial receptors expressions and endometrial morphology on endometrial receptivity at early stage of embryo implantation in the course of in vitro fertilization and embryo transfer(IVF-ET) and frozen-thawed embryo transfer(FET). Methods:Eighty infertile patients receiving assisted reproduction were selected as study objects,the endometrial tissue samples were scraped at 6-10 days of positive urinary luteinizing hormone(LH),then HE staining and immunohistochemical SP method were used to analyze the intensities and distributions of estrogen receptor(ER),progesterone receptor(PR),and epidermal growth factor receptor(EGFR) in endometrium semiquantitatively.The outcomes of IVF-ET and FET were followed up,the infertile patients were divided into IVF-ET pregnancy group(18 cases),IVF-ET non-pregnancy group(26 cases),FET pregnancy group(14 cases),and FET non-pregnancy group(22 cases). Results:The scores of ER,PR,and EGFR in IVF-ET pregnancy group and FET pregnancy group were significantly higher than those in IVF-ET non-pregnancy group and FET non-pregnancy group(P<0.05).The ratio of secretory phase in IVF-ET pregnancy group and FET pregnancy group were higher than those in IVF-ET non-pregnancy group and FET non-pregnancy group,but there was no significant difference(P>0.05). Conclusion:The expressions of ER,PR,and EGFR in endometrium can affect endometrial receptivity at early stage of embryo implantation and the outcome of IVF-ET,which can be used as indexes to predict pregnancy outcome.