控制性超促排卵治疗对胎盘组织的病理学影响

Pathological effects of controlled hyperstimulation on placenta

目的探讨控制性超促排卵治疗对胎盘屏障的影响。方法选取2014年1月—2014年12月就诊并符合研究纳入排除标准的121名孕妇进行胎盘绒毛组织定量分析和胎盘超微结构观察。其中人工助孕组79例(鲜胚组39例和冻融组40例),正常妊娠组42例为自然妊娠孕妇。结果人工助孕组(鲜胚组和冻融组)与正常妊娠组比较,胎盘末梢绒毛血管数减少,血管占绒毛横切面积比减小(P<0.05),但绒毛面密度无差异(P>0.05)。鲜胚组与冻融组间比较,上述指标差异无统计学意义。鲜胚组及冻融组来源的胎盘ST细胞浆内更容易出现囊泡样及钙化改变,与正常妊娠组比较,差异有统计学意义,余核固缩、钙化以及绒毛间质水肿和纤维素沉积间差异无统计学意义。结论鲜胚组及冻融组的苏木精-伊红染色组织学没有显著改变,超微结构显示屏障基本结构正常。故没有证据证明控制性超促排卵周期是导致助孕组胎盘出现上述改变的原因,关于胎盘某些超微结构上的差异还需继续深入研究。

Objective To investigate the effect of controlled hyperstimulation on placental barrier.Methods A total of 121 pregnant women who met the criteria from January 2014 to December 2014 were selected.Among them,79 cases were in artificial pregnancy group(39 cases in fresh embryo group and 40 cases in freeze-thaw group),42 cases in normal pregnancy group were in natural pregnancy.The quantitative analysis of the placental villi tissue and the microstructural observation of the placenta were carried out.Results Compared with the normal pregnancy group,the number of villus vessels in the artificial pregnancy group(fresh embryo group and freeze-thaw group)decreased,and the ratio of blood vessels to the cross section area of villus decreased(P<0.05),but there was no difference in villus density(P>0.05).There was no significant difference in the above indexes between fresh embryo group and freeze-thaw group.The changes of vesicle-like and calcification in the ST cytoplasm of placenta from fresh embryo group and freeze-thaw group were more prone than that of normal pregnancy group.There was no significant difference in residual nucleus pyknosis,calcification,villus interstitial edema and cellulose deposition between fresh embryo group and freeze-thaw group.Conclusion There was no significant change in histology of hematoxylin-eosin staining in fresh embryo group and freeze-thaw group,and the basic structure of ultrastructure display barrier was normal.Therefore,there is no evidence that the controlled ovarian hyperstimulation cycle is the cause of the above changes in placenta in the assisted pregnancy group,and some ultrastructural differences in placenta need to be further studied.