GnRHa长方案促超排卵对种植窗ICAM-I表达的影响及其机制的探讨

The study on the effect and cause of long protocol controlled ovarian hyperstimulation by GnRHa on expresss of implantation window ICAM-1

目的研究Decapty1/HMG/HCG长方案促超排卵对子宫内膜ICAM-1表达的影响,分析ICAM-1变化与血清E2、P水平之间的相关性,探讨该方案高获卵率而低妊娠率的原因,为临床改善促排卵方案,提高IVF-ET的妊娠率提供理论依据。方法将小白鼠分为NC组和COH组,用免疫组化SP法观察两组小鼠pd1~pd6子宫内膜ICAM-1蛋白的表达。用罗氏电化学发光法检测两组小鼠pd1~pd6血清E2、P的水平。结果NC组中ICAM-1于pd4表达最明显（P（0.01）,COH组中ICAM-1于pd3表达最明显（P（0.01）。ICAM-1蛋白的表达高峰和血清高峰点P/E2呈正相关关系（r=0.756,P（0.01）。结论Decapty1/HMG/HCG可能通过改变血清E2、P水平,使子宫内膜种植窗开放异常,导致子宫内膜发育与胚胎发育不同步,降低子宫内膜接受性,这可能是影响IVF-ET妊娠率的重要原因。

Objective： To study on the effect of long protocol controlled ovarian hyperstimulation by Deeaptyl/HMG/HCG on the endometrial intercellular adhesion molecule - 1 （ ICAM - 1 ） protein expression and the level of serum Ez, P, analyse the possible relationship between the change of ICAM - 1 and the level of serum E2, P, determine the cause of higher rates of get ooeytes but lower pregnancy rates by the protocol, provide some themry proofs for ameliorat stimulation protocol, improve the rates of pregnancy in IVF - ET. Methods： The miees were randomly divided into NC group and COH group. ICAM - 1 protein expression were determined by immunohistoebemistry SP method from pdl to pd6 in the two group miees. The level of serum Ez, P were determined by eleetroebemilu- mineseenee assays from pdl to pd6 in the two group miees. Results： The peak expression was on the pd4 （ P 〈 0. 01） in NC group, the surge was on pd3 （ P 〈 0. 01 ） in COH group. The surge expression of ICAM - 1 protein was positively correlated with the ratios of serum P/E2 （ r =0. 756, P 〈 0. 01 ）. Conclusion： Controlled ovarian hyperstimulation by Deeaptyl/HMG/HCG may transform the level of serum Ez, P, lead to disorder of implantation window, embryo - endometrial asynehrony, decline the endometrial receptivity. This may be an important factor in influencing pregnancy rate in vitro fertilization.