四种子宫内膜容受性预测指标的比较性研究

Comparison of four predictive parameters for endometrial receptivity

目的研究子宫内膜分泌反应情况、雌孕激素受体(ER、PR)、整合素β1表达及子宫内膜厚度与形态四种指标与体外受精-胚胎移植(IVF-ET)治疗结局的关系。方法56例患者,在IVF治疗周期开始前、BBT升高5～7d行诊断性刮宫,刮出组织分别行HE染色和SP免疫组化染色检查内膜分泌反应、ER、PR及整合素β1,B超了解子宫内膜厚度及内膜形态(根据B超下内膜表现分为A、B、C三型)。结果子宫内膜分泌反应正常组中妊娠率及整合素β1含量均明显高于分泌反应不良组,P<0.05。妊娠组的整合素β1的含量及表达明显高于未妊娠组,P<0.01;A、B、C三型内膜相比妊娠率无差异,但A+B型内膜与C型相比则有显著性差异,P=0.027。结论整合素β结合子宫内膜分泌反应情况、子宫内膜形态能有效预测IVF-ET的预后。

Objective To compare four parmneters, endamertial histology, estrogen receptor （ER） and progesterone reeeptor （PR）, integrin β1 expression, endometrial types, in predicting emdometrial receptivity. Methods Fifty - six patients randomly underwent endometrial biopsy 5 - 7 days after BBT rising in IVF- ET cycles. ER, PR, and integrin β1 were detected in all specimens. Endometrial thickness and types （A, B, C） were measure by B- ultrasound. Result In the 34 women with normal secretory phase endometrium, 12 were pregnant （12/34）. While 5 women were pregnant in 22 poor secretory cases （5/22）, significantly lower than the normal secretory endometrial group （ P = 0.042）. Integrin β1 expression was significantly lower in poor secretory group than the normal group （ P 〈0.05）. No connection was observed between the concentration of ER, PR and secretory change of endometaium. Compared with C type endometrium, the pregnant rate was higher in type A and B groups （ P = 0.027）. Conclusion lntegrin β1 , combined with endometrial histology and sonngraphic type, is a reliable predictor of endometrial receptivity and the outcomes of IVF- ET.