Association Study Between Estrogen/Progesterone, Their Receptors And VEGF And Endometrial Receptivity

Objective: To study serum estradiol (E2), progesterone (Prog) and the endometrial expressions of estrogen receptor (ER), progesterone receptor (PR), vascular endothelial growth factor (VEGF) in women undergoing in vitrofertilization embryo transfer (IVF-ET). To elucidate the relationship of E2, Prog and VEGF, and assess whether they could be used to predict subsequent treatment success.Methods: The endometrium tissue samples and serum samples were obtained from 36 women undergoing IVF-ET in the Reproductive Medical Center , the First Affiliated Hospital of GuangXi University in the window of implantation (mid-luteal). The serum E2 and Porg level was measured by radioimmunoassay. The endometrial ER, PR, VEGF were detected by immunohistochemistry (Suppervision mouse/rabbit two step method). 36 women were devided into two groups by their treatment: the pregnancy group (16 patients) and the non-pregnancy group (20 patients ). The data were analyzed by SPSS13.0 for windows. Comparison of the average in the two groups was performed by t-test (α=0.05),Comparison of three samples's average was performed One-Way ANOVA. Relationship between two variables was performed by correlativity analysis. (α=0.05)Result: 1 The mean age of the two groups were 30.81士2.88 year in the pregnancy group and 30.64士3.63 year in the non-pregnancy group. The mean infertility duration of two groups were 6.19士3.25 year in the pregnancy group and5.82士3.50 year in the non-pregnancy group. the mean menstrual cycle of the two groups were28.13士2.41day in the pregnancy group and28.55士1.57day in the non-pregnancy group . There was no significant defference betwein the two groups ( P>0.05).2 There were significant difference in the mean the serum E2 level during the window of implantation (168.92±69.28 VS 178.51±59.15,P>0.05) , There were no significant defference in the mean serum Prog level during the window of implantation (17.77±6.17VS 17.67±4.56,P>0.05)。3 The serum Prog were divided into three gtuops by their level, the pregnacy in the serum Prog which from 15 ng/ml to 20ng/ml is the highest. There was no significant difference between the first group and the second group, P=0.051 There was significant difference between the fist group and the last group, P=0.00. There as significant difference between the second group and the last group, P=0.01.4 The endometrial ER staining was located in the nucleus during the window of implantation That the density of ER immunostaining in glandual epithelial, and stromal in two groups was no significant difference. (0.262±0.317 VS 0.330±0.349, P>0.05; ER 0.309±0.242 VS 0.218±0.234,P>0.05)5 The endometrial PR staining was located in the nucleus during the window of implantation. That the density of PR immunostaining in glandual epithelial in two groups was significant difference, (0.190±0.176 VS 0.538±0.414, P<0.05; 0.804±0.653 VS 1.105±0.911 ). That the density of PR immunostaining in stromal was no significant difference (0.804±0.653 VS 1.105±0.911, P>0.05 )6 The VEGF exprssion staining was located in the cytoplasm during the window of implantation. It exprssion is positive in the gland, luminal epithelium and is negative in the stromal. In the mid-secretory, claybank secretion was seen in the glandular cavity. The H-score integral of VEGF immunol histochemistry in the pregnancy group is higher than unpregnancy group. There is significant difference in the two groups.the mean±s.m.z one by one from the gland to the epithelium is 1.72±0.26 VS 1.02±0.25, P<0.05; 0.70±0.24 VS 0.49±0.25, P<0.05. There is no significance difference in the stroma between the two groups, 0.03±0.02 VS 0.02±0.01, P>0.05; The correlative analysis of VEGF in endometrial luminal epithelial and glandual epithelial with serum E2 level shows positive correlation in two groups and dose-dependent, gland epithelial r=0.56, P<0.05; luminal epithelial r=0.72, P<0.05. The correlative analysis of VEGF with serum Prog shows no statistics correlation in two groups gland epithelial r=0..06, P>0.05; luminal epithelial r=-0.24, P>0.05.Conclusion :1 The serum Prog exert a influence to the endometrial receptivity during the window of inplantation. The numerial value of Prog which is too low or too high will bring down the endometrial receptivity. The numerial value of Prog will be a indication in the endometrial receptivity.2 During the window of implantation , the ER immunostaining in glandual epithelial, and stromal need down regulate, the PR immunostaining in stromal do not affect the endometrial receptivity, but the PR immunostaining in stromal go down. The relation of the PR immunostaining in glandual epithelial and endometrial receptivity is close. The failure of the down regulation of PR may play down the endometrial receptivity .3 During the window of implantation, the VEGF expression in gland , epithelium is positive. VEGF is induced by E2, and their relation is positive correlation and is dosage-dependent. The relation of Prog and VEGF is noncorrelation.