| BackgroudIn 1992, the world health organization( WHO )investigated 8,500 infertile couples in developed countries,and found that 34% of the patients were with fallopian tube and pelvic factors, and 1/3 of them were with hydrosalpinx. Nowdays, the patients with salpingemphraxis could be treated by in vitro fertilization-embryo transfer(IVF-ET), but the clinical researches found that the patients with hydrosalpinx got a more lower pregnancy rate. The mechanism of how hydrosalpinx reduced the successful rate of IVF-ET remained unclear.Some researchers considered that the mechanism may be associate with automatic washing, embryo toxicity, endometrial receptivity, endometrial tissue blood flow, endometrial inflammatory,etc. Recently years, lots of studies focus on the endometrial receptivity as it's one of the most critical factors of IVF-ET. There is a short and sensitive period which endometrium allowing embryo to implant, which is called"implantation window". During this period, the endometrium is mediated by the secretion and expression of certain cytokines. If hydrosalpinx fluid impair the endometrial receptivity by influence the expression of these cytokines? This has become the hot spots of current study.ObjectiveTo investigate the expression of endometrial receptivity marker in women with hydrosalpinx, explore the effect of hydrosalpinx on endometrial receptivity, and estimate the relationship between endometrial receptivity marker and pregnancy outcome by combining the outcomes of IVF-ET. Material and MethodsA retrospective analysis was conducted on 954 patients ( 1102 cycles ) who underwent IVF-ET with tubal diseases in the Third Affiliated Hospital of Guangzhou Medical College from January 2005 to June 2009. The patients were divided into two groups: hydrosalpinx group ( group A ) which consisted of 49 patients(60 cycles), hibateral salpingemphraxis group(group B)which consisted of 905 patients(1042 cycles). The total amount of gonadotropin, amount of day of controled ovary hyperstimulation , number of follicles that diameter greater than 12mm on the day of hCG, number of oocytes aspirated, number of embryos tranferred, number of embryos frozen, fertilization rate, implantation rate, biochemical pregnancy rate, clinical pregnancy rate, multiplets pregnancy rate, first trimester abortion rate, after first trimester abortion rate and ectopic pregnancy rate in two groups were compared.ResultsThere was no significant difference between two groups with regard to the total amount of gonadotropin injection, amount of days of controled ovary hyperstimulation, numbers of embryo transfer and frozen, fertilization rate,implantation rate,embryo transfer cancellation rate, multiplets pregnancy rate, first trimester abortion rate,after first trimester abortion rate and ectopic pregnancy rate(P>0.05).The numbers of follicles greater than 12mm on the day of HCG,numbers of oocytes aspirated in group A were significantly less than the numbers in group B(P<0.05).The biochemical pregnancy rate in group A was significantly higher than that in group B, the clinical pregnancy rate in group A was significantly lower than that in group B(P<0.05).ConclusionThe presence of hydrosalpinx has a negative effect on the outcomes of IVF-ET. Material and Methods1 Patients 42 patients were recruited in the Third Affiliated Hospital of Guangzhou Medical College from June 2009 to December 2010. The patients were divided into two groups: hydrosalpinx group ( group A ) which consisted of 30 patients, and male factors infertility group ( group B ) which consisted of 12 patients. Endometrial tissue biopsies were performed during midluteal phase.2 Experimental methods(1) Hematoxylin and eosin stain was performed to judge the phase of endometrium.(2) Real time RT-qPCR was performed to detect the expression of mRNA of HOXA10 and LIF.(3) IHC and WB were performed to detect the expression of protein of HOXA10 and LIF.Results1 There is no patient with endometritis both in two groups.2 Compared with group B, the mRNA level of HOXA10 and LIF were lower in group A(P<0.05).3 The immunolocalization of HOXA10 protein was detected in endometrial stromal cells, whereas no immunolocalization was detected in endometrial glandular epithelial cells. LIF protein was detected both in endometrial glandular epithelial and stromal cells. The protein expression of HOXA10 and LIF in group A was lower than that in group B(P<0.05).4,WB showed that the protein expression of HOXA10 and LIF in group A was lower than that in group B(P<0.05).ConclusionThe mRNA and protein level of HOXA10 and LIF in endometrium of patients with hydrosalpinx were lower than that in control group. It means that the hydrosalpinx has impaired the endometrial receptivity.This might be the partial mechanism of why patients with hydosalpinx had a lower pregnancy rate. Material and MethodsAccording to the pregnancy outcome,the 30 paitents in hydrosalpinx group were divided into two groups:pregnancy group (6 patients) and non-pregnacy group(24 patients). Compare the expression of mRNA and protein of HOXA10 and LIF between two groups.Results1 There was no significant difference between two groups with regard to the expression of mRNA of HOXA10(P>0.05); both the IHC and WB showed that the protein level of HOXA10 in pregnacy group was significantly higher than that in non-pregnacy group (P<0.05)2 The expression of mRNA of LIF in pregnancy group was higher than in non-pregnacy group(P<0.05);IHC showed that the expression of protein of LIF in pregnancy group was higher than that in non-pregnacy group(P<0.05),but the WB did not showed that(P>0.05).ConclusionThe expression of HOXA10 and LIF in endometrium of patients with hydrosalpinx related closely to the pregnancy outcome of IVF-ET. |
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