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目的探讨种植窗期子宫内膜雌、孕激素受体(ER、PR)及血管内皮生长因子(VEGF)的表达与体外受精-胚胎移植(IVF-ET)结局的关系,选择能预测IVF-ET结局的良好而可靠的指标。方法2004-05-2005-01对郑州大学第二附属医院生殖中心40例拟行IVF-ET妇女,在IVF-ET前1周期采用免疫组化SP法和组织学积分H-score方法对ER、PR和VEGF在种植窗期子宫内膜中的表达进行定位和半定量分析。按IVF-ET后是否妊娠将40例不孕患者分为两组:妊娠组和未妊娠组。结果未妊娠组腔上皮、腺体PR表达较妊娠组强,差异有统计学意义(P<0·05),间质PR表达较妊娠组弱,差异有统计学意义(P<0·05);妊娠组和未妊娠组子宫内膜ER表达差异无统计学意义(P>0·05);VEGF在子宫内膜中的表达妊娠组较未妊娠组高,差异有统计学意义(P<0·05)。结论种植窗期子宫内膜腔上皮、腺体PR下调失败,间质PR表达减弱及子宫内膜VEGF的表达减弱可导致IVF-ET妊娠失败。种植窗期子宫内膜PR和VEGF的表达可作为预测妊娠是否成功的指标。
Objective To investigate the relationship between the expression of estrogen and progesterone receptor (ER, PR) and vascular endothelial growth factor (VEGF) and the outcome of in vitro fertilization-embryo transfer (IVF-ET) Good and reliable outcome for the outcome. Methods From 2004-05-2005-01, 40 cases of IVF-ET women were enrolled in the Reproductive Center of the Second Affiliated Hospital of Zhengzhou University. Immunohistochemical SP method and histological score H-score method were used in the first cycle of IVF-ET. PR and VEGF expression in the implantation window of the endometrium localization and semi-quantitative analysis. According to IVF-ET after pregnancy will be 40 cases of infertility patients were divided into two groups: pregnancy group and non-pregnant group. Results The expression of PR in uterine epithelium and gland of non-pregnant group was significantly higher than that of pregnancy group (P <0.05), while the expression of interstitial PR was weaker than that in pregnancy group (P <0.05) There was no significant difference in ER expression between pregnant group and nonpregnant group (P> 0.05). The expression of VEGF in endometrium was higher than that of non-pregnant group (P <0.05) · 05). Conclusion In the implantation window, endometrial cavity epithelium and glandular PR are down-regulated, the expression of interstitial PR is weakened and the expression of VEGF in the endometrium is weakened, which leads to the failure of IVF-ET pregnancy. The expression of PR and VEGF in the implantation window can be used as an index to predict the success of pregnancy.