小剂量阿司匹林在诱发排卵中对子宫内膜组织形态学的影响

The effect of low-dose aspirin on endometrial morphology in ovulation induction

目的 :探讨小剂量阿司匹林 ( aspirin)在诱发排卵过程中对子宫内膜组织形态学的影响。方法 :采用前瞻性随机双盲的方法 ,观察原因不明的不育妇女在克罗米酚( CC)促排卵治疗同时自月经第 1～ 2 0天连续服小剂量 aspirin 75mg/ d,于黄体期取血测定血栓素 A2 /前列环素 ( TXA2 / PGI2 )比值 ,超声测定子宫动脉血流阻力指数 ( RI)及取子宫内膜进行组织形态学分析。结果 :aspirin组 TXA2 / PGI2 比值、子宫血流 RI明显低于单用 CC组 ( P<0 .0 5,P<0 .0 1 )。子宫内膜腺体面积、周长、间质面积、腺 /间比值及雌、孕激素受体的数目均明显大于单用 CC组 ( P<0 .0 1 )。结论 :小剂量 aspirin可改善促排卵时CC所致的子宫内膜发育不良。

Objective: To study the effect of low dose aspirin on endometrial morphology in ovulation induction. Methods: This study was a prospective randomized clinical trial. 30 women with unexplained infertility were divided into 2 groups randomly. 15 cases were in each group. In the experimental group, women were treated with low dose of aspirin 75 mg, q.d. for 20 days beginning from the first day of menstruation during ovulation induction using clomiphene citrate (CC); in control group, women were only treated with the same ovulation induction regimen except aspirin. The blood was collected at one day before ovulation (next day of hCG injection) and at 10 day after ovulation for measuring the metabolites of thromboxane (TXA 2) and prostacyclin (PGI 2). Resistance index (RI) of uterine artery was determined by utrasonography, endometrial biopsy was taken at luteal phase for morphological examination.Results: At one day before ovulation, TXA 2/PGI 2 ratio and RI of uterine artery were significantly lower in aspirin group compared with control group ( P<0.05; P< 0.01 ). However, no significant difference was found at 10 day after ovulation. The surface area of glands and stroma, the circumference of glands and ratio of glands and stroma in endometrium were significantly greater ( P<0.01 ) in aspirin group, additionally the numbers of estrogen receptors and progesterone recptors were also significantly more as compared with those in control group ( P<0.01 ) Conclusion: Low dose aspirin therapy might improve endometrial development during ovulation induction using CC.