Detection The Hormone Level In Endometrial Polyps And Clinical Analysis For Infertility Women With Endometrial Polyps

Endometrial polyps (EP) is one of common endometrial diseases, which have a role in abnormal uterine bleeding, infertility and postmenopausal bleeding. EP is common in infertile women, but little is known about the relation between EP and infertility. The pathogenesis of EP is unclear yet, maybe relate to inflammation, tumor, and so on. It's also doubtful whether EP is related to endocrine misbalance. The present study includes the following two parts as bellows:Partâ… The Detection of Hormone Level in Endometrial Polyps and its Adjacent EndometriumObjective: To detect the presence of insulin-like growth factor-1 (IGF-1), insulin-like growth factor receptors-1 (IGF-1R), insulin (INS), estradiol (E₂), estrogen receptor (ER) and progesterone receptor (PR) in endometrial polyps, adjacent endometrium and normal endometrium in reproductive-age women, in order to acquire the clues of EP pathogenesis.Methods: All the patients were chosen from the Second Hospital of Hebei Medical University during December 2006 to October 2007. 52 reproductive-age women had diagnosed benign endometrial polyp were recruited as study group. 43 infertile women were recruited as control group, who were excluded pathological changes of endometrium, such as EP, and so on based on the finding of B type ultrasound and hysteroscopy, and infertility reasons of them were men factors or abnormal fallopian tube. There were no significant differences between two groups of their age (P>0.05). Enrolled women were excluded from present study if they suffered severe diseases, used hormones preparation or underwent cavitary uteri operation within 3 months. The body height and weight were measured for the calculation of body mass index (BMI).1 Endometrial polyps specimen in 14 EP women and endometrium specimen in 11 controls were reserved at -20℃to make homogenate. The concentrations of IGF-1 were detected by enzyme linked immunosorbent assay; the concentrations of E₂ were detected by chemiluminescent immunoassay. The results were analyzed using t test (t'test when variances were unequal), and data were represent by (mean±SD).2 Endometrial polyps specimen in 38 EP women and endometrium specimen in 32 controls were routinely reserved. The expression of IGF-1, IGF-1R, INS, ER and PR were detected by immunohistochemistry. The results were analyzed by rank sum test.Results:1 General informationThere were no significant differences between two groups of their age and BMI.2 Determination of IGF-1 and E₂ in homogenate concentrationsComparing with control group, the concentration of IGF-1 in the homogenate of EP is significant lower (P<0.05). There were no significant difference of concentration of E₂ in homogenate in the two groups (P>0.05).3 The expression of IGF-1, IGF-1R, INS, ER and PR in tissueIn EP group, endometrial polyps and adjacent endometrium tissues were respectively reserved, both of them had 38 cases, including 23 cases in proliferative phase and 15 cases in secretory phase. In the control group, 32 cases included 20 cases in proliferative phase and 12 cases in secretory phase.3.1 The expression of IGF-1In proliferative phase group, the expression of IGF-1 in the gland of EP were significant weaker than that in control group (P<0.05). Expression of IGF-1 in the stroma of the three parts including endometrial polyps, adjacent endometrium and normal endometrium showed no significant difference (P> 0.05).In secretory phase group, the expression of IGF-1 in the gland of EP and adjacent endometrium were all significant weaker than that in control group (P<0.05). Expression of IGF-1 in the stroma of the three parts showed no significant difference (P>0.05).3.2 The expression of IGF-1RIn proliferative phase group, the expression of IGF-1R in the gland of the three parts showed no significant difference (P>0.05). Expression of IGF-1R in the stroma of EP were significant weaker than that in control group (P<0.05).In secretory phase group, the expression of IGF-1R in gland and stroma of the three showed no significant difference (P>0.05).3.3 The expression of ERIn proliferative phase group, the expression of ER in gland and stroma of the three showed no significant difference (P>0.05).In secretory phase group, the expression of ER in gland and stroma of the three parts showed no significant difference (P>0.05).3.4 The expression of PRIn proliferative phase group, the expression of PR in gland and stroma of the three parts showed no significant difference (P>0.05).In secretory phase group, the expression of PR in gland of the three parts showed no significant difference (P>0.05), expression of PR in the stroma of EP were significant weaker than that in control group (P<0.05).3.5 The expression of INSIn proliferative phase group, the expression of INS in gland and stroma of EP were significant weaker than that in control group (P<0.05), expression of PR in the stroma of adjacent endometrium were significant weaker than that in control group (P<0.05).In secretory phase group, the expression of INS in the gland of EP were significant weaker than that in control group (P<0.05). Expression of INS in the stroma of the three parts showed no significant difference (P>0.05).Conclusions:1 The expression of IGF-1, IGF-1R and INS in the gland and/or stroma of EP itself and/or its adjacent endometrium were significant weaker than that in normal endometrium, which maybe lead the growth and differentiation of EP is hysteretic or free-running with normal endometrium.2 The expression of PR in the stroma of EP were significant weaker than that in normal endometrium in the secretory phase group, which maybe responsible to persistent growth of endo- metrium and pathogenesis of EP.3 The expression of IGF-1 and INS of adjacent endometrium of EP is weaker than that in normal endometrium, the difference of hormones presence and its sensitiveness to hormone between them maybe associate with formed process of EP.Partâ…¡Clinical Analysis of Hysteroscopic Diagnosis and Therapy for Infertility Women with Endometrial PolypsObjective: Through assess the results of hysteroscopic diagnosis and therapy for infertility women with endometrial polyps (EP), to investigate the relationship between EP and infertility. Methods: Retrospective study based on 136 infertility patients (58 of them with endometrial polyp), within 452 diagnostic hysteroscopies done in the second hospital of Hebei Medical University, from December 2006 to August 2007. Assess the prevalence of EP in different age groups (≤30,31³5,>35) of infertile patients and the prevalence in infertile women depending on the etiology of the infertility. The results were analyzed usingχ² test, P values less than 0.05 considered significant.Results:1 The prevalence of EP in infertile women (42.6%, 58/136) was higher than non-infertile women (35.4%, 112/316), but differences was not significant (P>0.05); The prevalence of EP in primary infertility (47.1%, 41/87) was significant higher than that in secondary infertility (34.7%, 17/49) and non- infertile women (35.4%,112/316, P<0.05); There were no significant differences between secondary infertility women and non-infertile women of EP prevalence (P>0.05).2 The prevalence of EP in infertile women of 31³5 age group (57.5%) was significant higher than that in≤30 age group (35.9%, P<0.05); the prevalence of EP showed no significant difference between 31³5 age group and >35 age group (38.9%),≤30 age group and >35 age group (P>0.05).3 The prevalence of EP in infertile women unknown aetiology was significant higher than those have other aetiology (P<0.05); the prevalence of EP showed no significant difference between the other groups and the group have no corresponding etiology of infertility (P>0.05).Conclusions:1 The prevalence of EP in primary infertile women is increase; EP is one of the etiologies of infertility.2 The prevalence of EP in infertile women is correlate with their age, the prevalence of EP is higher in 31³5 age group.3 The prevalence of EP is different in infertile women have different etiology; EP has a closed concern with infertile women whose etiology is unknown.