多囊卵巢综合征患者种植窗口期子宫内膜容受性的研究

Study on endometrium receptivity in patients with polycystic ovary syndrome during implantation window time

目的研究影响多囊卵巢综合征(PCOS)患者种植窗口期子宫内膜容受性的基因表达。方法 9例 PCOS 患者(PCOS 组)及7例非 PCOS 因男方原因不孕者(对照组)行阴道超声监测结合血清激素测定确定排卵时间,于种植窗口期对两组妇女进行子宫内膜活检,提取 cDNA,其中6例PCOS 患者应用含有21571个基因序列的寡核苷酸芯片进行扫描,经过分析后得到 PCOS 患者的子宫内膜与对照组相比的差异表达基因;另外3例 PCOS 患者进行实时荧光定量 PCR 实验检测基质金属蛋白酶26(MMP-26)基因的表达。结果 PCOS 患者种植窗口期子宫内膜的差异表达基因为116个,占全部表达基因的比例为1.23%(116/9421)。PCOS 组患者与对照组比较,表达上调的差异表达基因占0.12%(11/9421);表达下调的差异表达基因占1.11%(105/9421),其中,MMP-26在基因芯片中表达下调10.6倍。与对照组患者种植窗口期子宫内膜比较,3例 PCOS 患者子宫内膜 MMP-26基因的相对表达率(Ratio 值)分别为0.31、0.11和0.05。结论 PCOS 患者种植窗口期子宫内膜 MMP-26基因表达下调,提示 PCOS 患者存在子宫内膜容受能力下降。

Objective To explore the gene which might influence endometrium receptivity during the implantation window time in normal women and patients with polycystic ovary syndrome （PCOS）. Methods Transvaginal ultrasound were performed and serum estrogen and progestogen levels were measured in all women to monitor the exact time of ovulation. Endometrium biopsy was done in normal women and PCOS patients during implantation window time. Sixteen women were enrolled in this study, in which seven were normal women, and nine were PCOS patients, cDNA extraction was performed, matrix metalloproteinase 26 （MMP-26） primers were synthesized and real time fluorescent quantitative PCR was conducted using 13-actin gene as endogenous control. Results The ratios of MMP-26 were 0. 31, 0. 11 and 0. 05 in 3 patients with PCOS by real time fluorescent quantitative PCR, obviously decreased during implantation time compared with the normal women. Conclusions Our data suggest a lower expression of MMP-26 in implantation window time in patients with PCOS than in normal patients. This might indicate a declined capability of endometrium receptivity in implantation window time in patients with PCOS.