超排卵周期中高雌、孕激素水平对着床期子宫内膜整合素αvβ3、骨桥蛋白表达及子宫内膜容受性的影响  

Effects of high estradiol and progesterone levels in controlled ovarian hyperstimulation cycles on integrin αvβ3,osteopontin and endometrial receptivity

作　　者：林娜[1] 马艳萍[1] 武泽[1] 邓波[1] 李蕾[1] 董云华[1] 马蕊[1] 白云[1] 

机构地区：[1]云南省第一人民医院生殖一科,云南昆明650032

出　　处：《中国妇幼保健》2015年第9期1438-1442,共5页Maternal and Child Health Care of China

基　　金：云南省卫生科技项目计划〔2011WS0010〕

摘　　要：目的：探讨体外授精（IVF）超促排卵过程中超生理剂量的雌、孕激素对着床期整合素αvβ3、骨桥蛋白（OPN）表达的影响,从而推测IVF超促排卵所致的高雌、孕激素对子宫内膜容受性的影响。方法：2012年5月~2013年10月于该中心行IVF的33例因卵巢过度刺激综合征或过高孕酮水平取消新鲜周期胚胎移植的不孕症妇女为研究组,根据h CG日雌孕激素水平将研究对象分为3组：高E2组（E2≥5 210 pg/ml、P〈1.05 ng/ml）;高P组（P≥1.05 ng/ml、E2〈5 210 pg/ml）;高E2并高P组（P≥1.05 ng/ml、E2≥5 210p g/ml）,于取卵后7~8天用宫腔负压吸管（Pipelle管）取内膜组织。对照组为11例正常妇女,于超声监测排卵后7~8天同法取内膜,采用免疫组化SP法和组织学积分H-score法对整合素αvβ3、OPN,在种植窗期子宫内膜中的表达进行定位和半定量分析,比较不同雌孕激素水平在着床期对整合素αvβ3、OPN表达的影响,从而推测IVF超促排卵中高雌、孕激素对子宫内膜容受性的影响。结果：种植窗期高E2组、高P组、高E2并高P组患者与对照组比较整合素αvβ3、OPN的表达差异没有统计学意义。结论：仅仅依靠整合素αvβ3、OPN这两项指标的表达来推测子宫内膜的容受性是不可靠的。Objective： To explore the effects of high estradiol and progesterone levels in controlled ovarian hyperstimulation cycles on integrin αvβ3 and osteopontin expressions and endometrial receptivity in in vitro fertilization（ IVF）. Methods： From May 2012 to October 2013,33 infertile women undergoing controlled ovarian hyperstimulation（ COH） cancelled embryo transfer because of ovarian hyperstimulation syndrome（ OHSS） or excessive high progesterone level were selected as study groups,then they were divided into three groups according to serum estradiol and progesterone concentrations on the day of human chorionic gonadotrophin（ h CG） administration： high estradiol group（ estradiol ≥ 5 210 pg / ml, progesterone 1. 05 ng / ml）, high progesterone group（ progesterone ≥ 1. 05 ng / ml, estradiol 5 210 pg / ml）,and high estradiol ＋ high progesterone group（ progesterone≥1. 05 ng / ml,estradiol≥5 210 pg / ml）. Endometrial biopsy was performed at 7- 8 days after oocytes retrieval by using Pipelle tubes. Eleven healthy fertile women were selected as control group,endometrial biopsy was performed using the same method after the day of ovulation under ultrasonic monitoring. Positioning analysis and semi-quantitative analysis of integrin αvβ3 and osteopontin expressions in endometrium during the window of implantation were conducted by immunohistochemical SP method and H- score method; the effects of different estradiol and progesterone levels during implantation period on integrin αvβ3 and osteopontin expressions were compared to speculate the effects of high estradiol and progesterone levels on endometrial receptivity in COH. Results： There was no statistically significant difference in the expressions of integrin αvβ3 and osteopontin among high estradiol group,and high progesterone group,high estradiol ＋ high progesterone group. Conclusion： Speculating endometrial receptivity only based on integrin αvβ3 and osteopontin is unreliable.

关 键 词：超促排卵 整合素ΑVΒ3 骨桥蛋白 雌激素 孕激素 子宫内膜容受性 

分 类 号：R715[医药卫生—妇产科学]