长方案促超排卵对子宫内膜中转化生长因子-β及胞饮突的实验研究  

Effect of controlled ovarian hyperstimulation by GnRHa on TGFβ1 in endometrium

作　　者：王芳[1] 周华[1] 陈碧[2] 李冰[1] 

机构地区：[1]广州医学院第三附属医院妇产科,广州510150 [2]广东医学院附属医院妇产科

出　　处：《中国生育健康杂志》2011年第4期213-217,F0003,共6页Chinese Journal of Reproductive Health

基　　金：基金项目：广东省医学科研基金项目（112010271）广东省自然科学基金资助（编号：5002464）

摘　　要：目的 观察促性腺激素释放激素激动剂（GnRHa）促超排卵对子宫内膜转化生长因子-β（TGFβ1）蛋白表达的影响,及其与胞饮突和血清E2、P水平之间的相关性,探讨GnRHa方案低妊娠率的原因,为临床提高体外受精-胚胎移植（IVF-ET）妊娠率提供理论依据.方法 随机将96只雌鼠分成两组,自然周期组和控制性促超排卵组.应用扫描电镜观察子宫内膜胞饮突的表达,应用免疫组化SP法观察子宫内膜TGFβ1蛋白的表达,应用放射免疫法检测雌二醇（E2）、孕酮（P）水平.结果 GnRHa促超排卵可能通过改变血清E2、P水平,使子宫内膜TGFβ1蛋白表达高峰前移,使子宫内膜种植窗异常,导致子宫内膜发育与胚胎发育不同步,降低子宫内膜容受性,影响IVF-ET妊娠率.结论 GnRH促超排卵影响子宫内膜的植入窗.Objective To assess the effect of controlled ovarian hyperstimulation by GnRHa/HMG/HCG on trans- forming growth factor beta I （TGFβ1） protein expression in endometium, to examine the relationship of TGFβ1 with pinop- od and levels of serum estradiol （ E2 ） and progesterone （ P）, and to understand the underlying causes of higher rates of oo- cytes but lower pregnancy rates by GnRHa. Methods Ninty-eight mice were randomly divided into two groups. Natural cycle （NC） group was treated with injection with 0. 9 % salt solution while controlled ovarian hyperstimulation （COH） group was treated with GnRHa ＋ HMG ＋ HCG. Endometrial pinopod expression in NC and COH groups was determined by scanning electron microscopy （SEM）. The expressions of TGFβ1 protein was examined by immunohistochemistry SP meth- od. The level of serum E2 and P were determined by paramagnetic-particle chemiluminescent immunoassay. Results In NC group, TGFβ1 protein distributed around cytoplasm of uterine epithelium cell, glandular epithelium cell, and stroma; the peak expression was on pd4 in NC group, and on pd3 in COH group. The peak expression of serum E2 and P was on pd4 in NC group, and on pd3 in COH group. The peak of pinopod score was positively correlated with the ratios of serum P/E2 （r = 0. 633, P 〈0.01 ）. The surge expression of TGFβ1 protein was positively correlated with the ratios of serum P/ E2 （r = 0. 658, P 〈 0.01 ）. Conclusion Corn：rolled ovarian hyperstimulation by GnRHa may transform the level of serum E2 and P, leading to disorders of implantation window, embryo-endometrial asynchrony, and the decline in the endometrial receptivity. This may be an important factor influencing pregnancy rate in vitro fertilization. Therefore, it is important to monitor the level of serum E2 and P during ovarian stimulation cycles.

关 键 词：控制性促超排卵 种植窗 生长转化因子β1 子宫内膜容受性 

分 类 号：R711.6[医药卫生—妇产科学]