内膜搔刮对RIF患者子宫内膜着床窗口期LPAR3和HOXA11表达的影响及临床意义  

Effect of endometrial scratching on LPAR3 and HOXA11 expressions during endometrial implantation window period in RIF patients and the clinical significance

作　　者：赵华[1] 李豫峰[1] 郭娜[1] 谭美华[1] 杜瑶瑶[1] 

机构地区：[1]华中科技大学附属同济医院生殖中心,湖北武汉430000

出　　处：《中国妇幼保健》2015年第21期3639-3644,共6页Maternal and Child Health Care of China

摘　　要：目的探讨对反复移植失败（RIF）患者进行内膜搔刮后，比较溶血磷脂酸受体3（LPAR3）和同源框基因11（HOXA11）在搔刮组与对照组子宫内膜着床窗口期蛋白的表达差异及临床结局。方法前瞻性纳入61例因输卵管因素不孕行IVF—ET助孕治疗的RIF患者作为研究对象，搔刮组31例患者于冻胚复苏移植的前1个月经周期月经来潮6h内进行内膜搔刮，对照组30例患者在冻胚复苏移植前未行内膜搔刮。采用免疫组化和WesternBlot的实验方法，检测LPAR3和HOXAll在以上两组RIF患者排卵后5～7天子宫内膜窗口期蛋白表达量的差异和临床结局。结果两组患者在年龄、不孕年限、体重指数（BMI）、促性腺激素（Gn）天数、Gn总量、获卵数、胚胎移植数、移植日内膜厚度、基础血清卵泡刺激素（FSH）、黄体生成素（LH）及孕酮（P）及着床窗口期血清雌二醇（E2）、P水平相比较，差异无统计学意义（P〉0．05），搔刮组生化妊娠率、胚胎着床率、临床妊娠率及持续妊娠率均高于对照组，有统计学差异（P〈0．05）。免疫组化结果显示搔刮组腺上皮LPAR3及间质HOXAll在子宫内膜着床窗口期的表达量明显高于对照组，而搔刮组腺上皮HOXAll在子宫内膜着床窗口期的表达量明显低于对照组，差异有统计学意义（P〈0．001）。WesternBlot结果显示搔刮组LPAR3和HOXAll蛋白在着床窗口期的表达量明显高于对照组，有统计学差异（P〈0．001）。结论子宫内膜搔刮术可以提高LPAR3和HOXAll的表达量，从而改善子宫内膜容受性，提高RIF患者的临床妊娠率。Objective To explore the differences of lysophosphatidic acid receptor 3 （ LPAR3 ） and homeobox gene 11 （ HOXA11 ） expressions during endometrial implantation window period and clinical outcomes between the repeated implantation failure （RIF） patients after endometrial scratching and control group. Methods Sixty-one patients with RIF scheduled for in vitro fertilization and embryo transfer because of tubal infertility were selected as study objects, 31 patients in endometrial scratching group underwent endometrial scratching within six hours in a previous menstrual cycle, while 30 patients in control group did not receive endometrial scratching before frozen embryo transfer. Immunohistoehemical method and Western Blot were used to detect the differences of LPAR3 and HOXA11 expressions during endo- metrial implantation window period （5- 7 days after ovulation） and clinical outcomes between the two groups. Results There was no statistically significant difference in age, duration time of infertility, body mass index （BMI）, application time and total dose of gonadotropin （ Gn）, the number of retrieved oocytes, the number of embryos transferred, the endometrial thickness on the day of ET, basic serum follicle -stimulating hormone （FSH）, luteinizing hormone （LH）, progesterone （P）, and serum estradiol and P levels during endometrial implantation window period between the two groups （P〉 O. 05 ） . The biochemical pregnancy rate, embryo implantation rate, clinical pregnancy rate, and ongoing pregnancy rate in endometrial scratching group were statistically significantly higher than those in control group （P〈0.05） . The results of immunohistochemical method showed that the expression levels of LPAR3 in glandular epithelium and HOXA11 in mesenchyme in endometrial scratching group were statistically significantly higher than those in control group （ P〈O~ 05 ） . The expression level of HOXA11 in glandular epithelium during endometrial implantation window period in endometr

关 键 词：子宫内膜容受性 子宫内膜搔刮术 同源框基因11 溶血磷脂酸受体3 着床窗口期 RIF 

分 类 号：R714[医药卫生—妇产科学]