To evaluate the clinical response and endometrial morphology during the implantation window on ovarian hyperstimulation with the aromatase inhibitor letrozole in infertile ovulatory women. Prospective trial in inferti...To evaluate the clinical response and endometrial morphology during the implantation window on ovarian hyperstimulation with the aromatase inhibitor letrozole in infertile ovulatory women. Prospective trial in infertile patients. Tertiary care hospital. Eight ovulatory infertile patient candidates for ovarian superovulation. Subjects were monitored in one control cycle. In the next cycle, they received letrozole 5.0 mg daily on days 3 through 7 after menses. Number of ovulatory follicles; dominant follicle diameter; endometrial thickness; hormonal profile of FSH, LH, E2, A, T, and P; endometrial histological dating;and pinopode formation assessed by scanning electron microscopy. Cycles stimulated with letrozole resulted in more ovulatory follicles than did natural cycles (mean ± SD 2.0 ± 0.9 vs. 1.0 ± 0.0), which attained a greater preovulatory diameter (mean ± .SD 23.8 ± 2.7 vs. 19.3 ± 2.1 mm), with similar endometrial thickness at midcycle compared with spontaneous cycles. Endocrine profile of medicated cycles was characterized on day 7 by increased levels of LH (5.9 ± 0.8 vs 3.5 ± .0.4 IU/mL), reduced E2 (98.4 ± 11.4 vs. 161.5 ± 14.7 pmol/L), and elevated androgens. Preovulatory and midsecretory E2 were similar to spontaneous cycle, and P levels during midluteal phase were significantly elevated (44.2 ± 4.6 vs. 27.7 ± 4.6 pmol/L). Endometrial morphology during the implantation window in letrozole- stimulated cycles was characterized by inphase histological dating and pinopode expression on scanning electron microscopy. Letrozole induces moderate ovarian hyperstimulation in ovulatory infertile patients with E2 levels similar to spontaneous cycles and higher midluteal P,leading to both a normal endometrial histology and development of pinopodes,considered to be relevant markers of endometrial receptivity.展开更多
目的:观察二补助育汤对胚胎着床障碍模型小鼠子宫内膜胞饮突及环氧合酶-2(COX-2)表达的影响。方法:56只雌性C57小鼠随机分为空白组,模型组,补佳乐组,阿司匹林组,二补助育汤低、中、高剂量组,建立胚胎着床障碍动物模型,并予相应药物灌胃...目的:观察二补助育汤对胚胎着床障碍模型小鼠子宫内膜胞饮突及环氧合酶-2(COX-2)表达的影响。方法:56只雌性C57小鼠随机分为空白组,模型组,补佳乐组,阿司匹林组,二补助育汤低、中、高剂量组,建立胚胎着床障碍动物模型,并予相应药物灌胃,妊娠第5天处死小鼠后,检测各观察指标。结果:模型组小鼠平均胚胎着床位点数、胞饮突评分、COX-2蛋白表达明显低于空白组(P<0.05);与模型组比较,二补助育汤中、高剂量组平均胚胎着床位点数、二补助育汤中剂量组胞饮突评分及二补助育汤各剂量组COX-2蛋白表达显著增加(P<0.05),且胞饮突表达和发育良好,COX-2 m RNA表达增加。结论:二补助育汤能够促进子宫内膜胞饮突及COX-2表达,提高子宫内膜容受性,有利于胚胎着床。展开更多
文摘To evaluate the clinical response and endometrial morphology during the implantation window on ovarian hyperstimulation with the aromatase inhibitor letrozole in infertile ovulatory women. Prospective trial in infertile patients. Tertiary care hospital. Eight ovulatory infertile patient candidates for ovarian superovulation. Subjects were monitored in one control cycle. In the next cycle, they received letrozole 5.0 mg daily on days 3 through 7 after menses. Number of ovulatory follicles; dominant follicle diameter; endometrial thickness; hormonal profile of FSH, LH, E2, A, T, and P; endometrial histological dating;and pinopode formation assessed by scanning electron microscopy. Cycles stimulated with letrozole resulted in more ovulatory follicles than did natural cycles (mean ± SD 2.0 ± 0.9 vs. 1.0 ± 0.0), which attained a greater preovulatory diameter (mean ± .SD 23.8 ± 2.7 vs. 19.3 ± 2.1 mm), with similar endometrial thickness at midcycle compared with spontaneous cycles. Endocrine profile of medicated cycles was characterized on day 7 by increased levels of LH (5.9 ± 0.8 vs 3.5 ± .0.4 IU/mL), reduced E2 (98.4 ± 11.4 vs. 161.5 ± 14.7 pmol/L), and elevated androgens. Preovulatory and midsecretory E2 were similar to spontaneous cycle, and P levels during midluteal phase were significantly elevated (44.2 ± 4.6 vs. 27.7 ± 4.6 pmol/L). Endometrial morphology during the implantation window in letrozole- stimulated cycles was characterized by inphase histological dating and pinopode expression on scanning electron microscopy. Letrozole induces moderate ovarian hyperstimulation in ovulatory infertile patients with E2 levels similar to spontaneous cycles and higher midluteal P,leading to both a normal endometrial histology and development of pinopodes,considered to be relevant markers of endometrial receptivity.
文摘目的:观察二补助育汤对胚胎着床障碍模型小鼠子宫内膜胞饮突及环氧合酶-2(COX-2)表达的影响。方法:56只雌性C57小鼠随机分为空白组,模型组,补佳乐组,阿司匹林组,二补助育汤低、中、高剂量组,建立胚胎着床障碍动物模型,并予相应药物灌胃,妊娠第5天处死小鼠后,检测各观察指标。结果:模型组小鼠平均胚胎着床位点数、胞饮突评分、COX-2蛋白表达明显低于空白组(P<0.05);与模型组比较,二补助育汤中、高剂量组平均胚胎着床位点数、二补助育汤中剂量组胞饮突评分及二补助育汤各剂量组COX-2蛋白表达显著增加(P<0.05),且胞饮突表达和发育良好,COX-2 m RNA表达增加。结论:二补助育汤能够促进子宫内膜胞饮突及COX-2表达,提高子宫内膜容受性,有利于胚胎着床。
基金supported by the Natural Science Foundation of Zhejiang ProvinceChina(No.LQ17C050001)+3 种基金the Fundamental Research Funds for the Central Universities of China(No.2015QNA7028)the Experimental Technology Research Program of Zhejiang University(No.SYB201510)the Research Foundation of Zhejiang Chinese Medical UniversityChina(No.2018ZY36)
