原因不明不孕患者子宫内膜胰岛素样生长因子-Ⅱ和Ⅰ型受体的表达与性激素的调控

Endometrial insulin-like growth factor Ⅱ and type Ⅰ receptor in unexplained infertility and its steroid regulation

目的 :探讨原因不明不孕患者子宫内膜胰岛素样生长因子 - (IGF- )及其 型受体 (IGF- R)的表达 ,血清性激素的变化与子宫内膜接受性的关系。方法 :采用逆转录聚合酶链反应 (RT- PCR)技术 ,对 34例原因不明不孕患者 (研究组 )和 2 1例正常生育妇女志愿者或男性因素不孕妇女 (对组照 )的黄体中期子宫内膜 ,行 IGF- 及 IGF- R m RNA检测 ,放射免疫法测定同期血清雌二醇 (E2 )、孕酮 (P)水平。结果 :研究组黄体中期子宫内膜IGF- m RNA、IGF- R m RNA表达水平分别为 0 .6 6 2± 0 .371、0 .5 82± 0 .2 5 7,低于对照组 0 .96 1± 0 .389、0 .82 9± 0 .341(均 P<0 .0 5 )。研究组血清 P水平为 (2 3.782± 15 .4 5 9) nmol/ L ,显著低于对照组 (43.14 2± 16 .5 49) nmol/ L(P<0 .0 0 5 ) ,而两组 E2 无显著性差异。相关分析示两组 IGF- m RNA与 IGF- R m RNA均呈正相关 ,r分别为0 .92 3、0 .738(P<0 .0 5 )。两组 P与 IGF- m RNA均呈正相关 ,r分别为 0 .716、0 .5 88(P<0 .0 5 )。两组 P与 IGF- R m RNA均呈正相关 ,r分别为 0 .5 19、0 .5 0 5 (P<0 .0 5 )。结论 :原因不明不孕患者黄体中期孕激素不足可引起子宫内膜 IGF- 及 IGF- R基因表达减弱 ,影响子宫内膜蜕膜化而导致子宫内膜接受性低下 ,

Objective: To investigate the endometrial expression of insulin like growth factor Ⅱ(IGF Ⅱ) and type Ⅰ receptor (IGF ⅠR) in unexplained infertility. Methods: Reverse transcription polymerase chain reaction (RT PCR) was used to detect and quantify endometrial IGF Ⅱ and IGF Ⅰ R mRNA experession in the mid luteal phase. Serum concentrations of estradiol (E 2) and progesterone (P) were measured by radioimmunoassays.Thirty four women with unexplained infertility were included in the study group. Twenty one women with normal fertility were selected as the control group. Results: Endometrial IGF Ⅱ and IGF Ⅰ R mRNA expression during the mid luteal phase were significantly lower in the study group than in the control group (0.662±0.371 vs 0.961± 0.389 , P <0.05;0.582±0.257 vs 0.829±0.341, P <0.05 respectively). The average serum P level in the study group was significantly lower than in the control group (23.782±15.459 vs 43.142±16.549nmol/L, P <0.005). IGF Ⅱ mRNA expression correlated positively with IGF Ⅰ R mRNA expression in the two groups. Serum P level correlated positively with IGF Ⅱ and IGF Ⅰ R mRNA expressions in the two groups. Conclusion: IGF Ⅱ and IGF Ⅰ R may play an important role in the implantation process. Their decreased expression relating to decreased P level may be important in unexplained infertility.