| Objective To investigate the relationship betweeen the heparin-binding epidermal growth factor (HB-EGF) and endometrial receptivity during the window of implantation in vitro fetilization-embyro transfer(IVF-ET) by detecting the content of HB-EGF in serum, follicular fluid and endometrium in order to promote the clinical pregnancy rate of IVF-ET.Methods 56 patients had their first IVF/ICSI cycles at the Reproductive Medicine Center in Affiliated Hospital of Ningxia Medical University.The expression of HB-EGF mRNA in the endometrium was measured during the early follicular phase and midluteal phase by the RT-PCR. The HB-EGF levels in the serum and follicular fluid were measured by ELISA. Two-sample t-test, chi-square test and pearson correlation analysis were used for statistical analyses by performing SPSS 11.5 software.Results (1)The expression of HB-EGF mRNA in the endometrium during the midluteal phase was significantly higher than the early follicular phase's(1.65±0.87vs.0.55±0.20, P <0.01), the same as the result of the short protocol patients(1.44±0.55 vs.0.57±0.25, P <0.01).It also was significantly higher in the pregnancy group than the non-pregnancy group's(2.39±0.60vs.1.14±0.61, P <0.01).(2)There were significant positive correlation between the expression of HB-EGF in the endometrium and levels of E2,P during the midluteal phase(P all <0.05). (3)There were significant positive correlation between the expression of HB-EGF mRNA in the endometrium and endometrial thickness (P <0.001),which in the group of endometrial thickness above 9mm was significantly higher than that less than 9mm (1.86±0.85 vs.0.89±0.31, P <0.001)(.4)The HB-EGF levels in the right follicular fluid was significantly higher than the left's (282.56±164.47 vs.197.53±164.16, P <0.01)(.5)The HB-EGF levels in the follicular fluid of the pregnancy group was significantly higher than the non-pregnancy group's (270.42±52.25 vs.198.51±40.18, P <0.05).(6)HB-EGF levels in the serum and follicular fluid of the PCOS group were significantly higher than the non-PCOS group's (P all <0.01).(7)The endometrial HB-EGF mRNA levels of the unexplained infertility during the midluteal phase was significantly lower than the male factor group's (1.42±0.25 vs.1.91±0.28, P <0.05).(8)The endometrial HB-EGF mRNA levels of the secondary infertilty during the midluteal phase was significantly lower than the primary infertility group's (1.16±0.66 vs.1.87±0.85, P <0.05).Conclusions (1)There is a periodic variation for the expression of HB-EGF in the endometrium. HB-EGF levels during the midluteal phase is higher than the early follicular phase's, indicating that the expression of HB-EGF during the window of implantation may be one of indexer for IVF-ET pregnancy outcome.(2)There are synergistic effects between HB-EGF and E2,P. And the HB-EGF mRNA may mediate the growth of endometrium,improving the endometrial receptivity synergistically.(3)HB-EGF of the follicular fluid in the right ovary is more than the left's, indicating that there are physiological differences of ovarian reproductive function between the left and right side.(4)The expression of HB-EGF may play a main role in the pathology and physiology of PCOS and affect the maturation and quality of oocytes.(5)Lower HB-EGF could be one of the molecular mechanism of unexplained infertility.Some injured factors such as abortion,curettage and so on may lead to poor endometrial receptivity.(6)Further study on the mechanism of embryo implantation and regulation factors of HB-EGF, could provide the theoretical basis for human reproduction, ART and development of anti-implantation medication. |
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