胚胎移植前宫腔内灌注hCG在IVF-ET中的应用及hCG提高种植率和妊娠率的有关机制

Application of the Established Method of Intrauterine Infusion of hCG before Embryo Transfer in IVF-ET and Mechanisms of hCG to Improve the Implantation and Pregnancy Rates

人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)是由胎盘合体滋养细胞合成的一种糖蛋白激素,具有维持黄体寿命、刺激雌孕激素合成、抑制植物血凝素对淋巴细胞的增殖作用等功能。最近研究表明,胚胎移植前宫腔内灌注hCG可显著提高移植后的种植率和妊娠率,但其具体作用机制尚未完全弄清,可能与宫腔内灌注一定浓度hCG后,其能以旁分泌形式作用于子宫内膜上皮细胞和血管内皮细胞等的表面受体而发挥作用,进而促使母-胎界面血管形成、增强母-胎间的免疫耐受有关;还可能与延长子宫内膜的移植窗,使子宫内膜容受性增强有关。

Human chorionic gonadotropin（hCG）,a glycoprotein which is synthesized by the placenta syncytiotrophoblasts has multiple functions,such as maintaining the life of corpus luteum,stimulating the synthesis of estrogen and progesterone,inhibiting the proliferation reaction of lymphocytes responding to phytohemagglutinin and so on.A recent study has found that the application of intrauterine infusion of hCG before embryo transfer can significantly improve the implantation and pregnancy rates in IVF-ET,however,its’exact regulating mechanism is not fully understood by researchers,it may be explained by the previous proved value of hCG,for example,when it was infused into the uterine cavity up to a certain concentration,it can play a paracrine role on promoting immunologic tolerance and angiogenesis at the maternal-fetal interface via its interaction with endometrial and endothelial hCG receptors;in addition,it may in part be explained by increasing the duration of the implantation window of endometrial as well as enhancing the receptivity of uterine.