宫腔灌注人绒毛膜促性腺激素改善多囊卵巢综合征患者子宫内膜容受性  

Intrauterine infusion of human chorionic gonadotrophinimproves endometrial receptivity in patients with polycystic ovarian syndrome

作　　者：孙家珍[1] 潘瑞洋 申素芳[1] SUN Jia-zhen;PAN Rui-yang;SHEN Su-fang(Department of Reproductive Medicine,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,China;Department of Cardiology, the Third Affiliated Hospital of Xinxiang Medical University, Xinxiang 453003,China)

机构地区：[1]新乡医学院第三附属医院生殖医学科,河南新乡453003 [2]新乡医学院第三附属医院心血管内科,河南新乡453003

出　　处：《基础医学与临床》2020年第4期496-500,共5页Basic and Clinical Medicine

基　　金：新乡市科技创新人才计划(CXRC16004)。

摘　　要：目的探讨宫腔灌注人绒毛膜促性腺激素(hCG)对多囊卵巢综合征(PCOS)患者子宫内膜容受性、雌孕激素及其受体的影响。方法对照组(n=23)为健康女性,研究组为PCOS患者。研究组1(n=25)给予口服来曲唑;研究组2(n=20)口服来曲唑同时于排卵前2日及排卵日分别给予hCG 500 IU/mL宫腔灌注1次。各组均于排卵后第6~8天抽取子宫内膜,行免疫组织化学染色检测雌激素受体(ER)及孕激素受体(PR)的表达;扫描电镜(SEM)观察子宫内膜胞饮突;于取内膜当日用化学发光法检测血清雌激素(E2)和孕激素(P)的浓度;于排卵后16 d计算各组妊娠率。结果研究组1成熟期胞饮突的表达率低于对照组,研究组2成熟期胞饮突的表达率高于研究组1(P<0.05)。研究组1着床窗期P水平、子宫内膜PR阳性表达率均低于对照组,研究组2着床窗期P水平、子宫内膜PR阳性表达率均高于研究组1(P<0.05)。研究组1妊娠率低于对照组,研究组2妊娠率高于研究组1(P<0.05)。结论PCOS患者着床窗期胞饮突发育不良;宫腔灌注hCG可能使成熟期胞饮突数量增加,改善子宫内膜容受性,其机制可能与P水平升高、PR表达增加有关。Objective To investigate the effect of intrauterine infusion of human chorionic gonadotrophin(hCG)on endometrial receptivity,estrogen and progesterone and their receptors in patients with polycystic ovary syndrome(PCOS).Methods The control group(n=23)consisted of healthy females,the study group consisted of PCOS patients.The study group 1(n=25)was given letrozole,and the study group 2(n=20)was given letrozole.Two days before ovulation and on the ovulation day,hCG 500 IU/mL was intraperitoneally administered.Endometrium was taken from D6 to D8 after ovulation in each group.Immuno-histochemical staining was used to detect the expression of estrogen receptor(ER)and progesterone receptor(PR).Scanning electron microscopy(SEM)was used to observe endometrial pinopode.The serum estrogen(E2)and progesterone(P)were examined by through chemi-luminescence on the endometrial day.Sixteen days after ovulation,the pregnancy rate of each group was calculated.Results The expression rate of the mature stage pinopode in the study group 1 was lower than that in the control group.The expression rate of the mature stage pinopode in the study group 1 was higher than that of study group 1(P<0.05).The P level of the implantation window and the positive expression rate of PR in the study group 1 was lower than that in the control group.The P level of the implantation window and the positive expression rate of PR in the study group 1 was higher than that in the study group 1(P<0.05).The pregnancy rate of study group 1 was lower than that of the control group,and the pregnancy rate of study group 2 was higher than that of study group 1(P<0.05).Conclusions PCOS patients are stunted during the implantaqtion window.Intrauterine perfusion of hCG may increase the number of mature pinopode and improve endometrial receptivity.This is potentially related to increased P level and PR expression.

关 键 词：多囊卵巢综合征 宫腔灌注 人绒毛膜促性腺激素(hCG) 胞饮突 

分 类 号：R711.75[医药卫生—妇产科学]