| The incidence of infertility is increasing year by year, the average rate of10%, to become an important factor affecting family harmony, and in vitro fertilization-embryo transfer (IVF-ET) and other assisted reproductive technology Infertility Treatment revolutionary enhance normalpregnancy after ovulation, fertilization, cleavage, implantation of four links, each link abnormalities can cause implantation failure, embryo quality and endometrial environment is the most important factor affecting the embryo implantation and clinical pregnancy rate. Controlled ovarian hyperstimulation, the embryo laboratory techniques improved, making the number of embryos, the quality can be optimized, combined with embryo transfer technology continues to improve, but IVF-ET cycle pregnancy rate is still hovering at40%, the main reason may be the uterus endometrial embryo transfer related to the environment. The large number of domestic and international studies have shown that endometrial environment mainly refers to the receptivity of the endometrium. Humans can accept implantation endometrial environment exists only in a particular period, the implantation window period (after ovulation5-7d). The subject LPAR3and HOXA11two indicators, selected on the basis of previous experiments, explore their expression after intervention therapy of endometrial receptivity for implantation window. The large number of domestic and foreign scholars have tried a variety of ways to improve endometrial receptivity, including Chinese and Western medicines and surgical treatment. Endometrial curettage and proprietary Chinese medicines (promote menstruation pregnancy pill) selected according to the center’s experience in the treatment of this topic is not pregnant patients in the early and experimental intervention therapy.ObjectiveThe study lysophosphatidic acid receptor3(LPAR3) and homeobox gene11(HOXA-11) gene and protein expression in endometrial implantation window period aftermanual intervention, to explore better methods of endometrial receptivityand to seek the most appropriate method to improve the clinical pregnancy rate of assisted reproductive technology.MethodsPrevious studies of the Third Affiliated Hospital of Zhengzhou University, Center for Reproductive Medicine69non-pregnant patients were randomly divided into three groups, including20cases of endometrial scraping technique (experimental group1) and oral medicine (promoting pregnancy pill menstruation)21(experimental group),28patients (control group) did not undergo interventions.Interventions:①endometrial scraping technique before2transplantation menstrual cycle menstrual cramps within24hours, after voiding bladder lithotomy position, to identify uterine size and position; the routine disinfection and shop towels hole, vaginal speculum exposurecervix, povidone-iodine disinfection of the cervix and cervical os, cervical clamp to hold the cervix9:00to11:00position, probe measurement uterine cavity depth, small curette is then sent to the palace at the bottom, gently superficial uniform scrapinguterine cavity intimal surface.②proprietary Chinese medicines (promote menstruation pregnancy pill) patients were treated with promoting pregnancy pill menstruation, a5g,2times a day, the fifth day since the menstrual cycle and even served20days; no period of application of20 days a month, and even served two courses three menstrual cycle, the early use of ovulation drugs to induce ovulation, pre-transplant seven days after ovulation, while access to the window of implantation endometrium.The specimens Get take endometrial:①to obtain endometrial:5-7days after ovulation scheduling for the pre-transplant underwent IVF embryos, and then a one-time endometrial sampler proven uterine cavity depth and obtain a small amount of endometrial tissue, and then the innermembrane of duplicate points directly into the a3ml disposable sterile test tube was frozen in liquid nitrogen, to be semi-quantitative RT-PCR, and western blot detection LPAR3and HOXA11gene and protein expression.②serum sex hormone determination:Take the day of the endometrial extraction the subjects fasting peripheral venous blood the3ml measured estrogen and progesterone levels.The experimental data to represent the mean±standard deviation form. Quantitative data and in accordance with normal distribution and homogeneity of variance using ANOVA analysis of qualitative data using the chi-square test. SPSS17.0statistical software for statistical analysis. P<0.05was statistically significant.Result1Comparison of the clinical data of the experimental group and the’ control group.Three sets of clinical data comparison, the experimental group, the average age, BMI, duration of infertility, and type of chelating, basal blood FSH, LH, E2value, number of embryos transferred implantation window bloodE2, p-value level had no significant difference (p>0.05), the experimental group clinical pregnancy rate higher than that of the control group, the difference was statistically significant (p<0.05), but the experimental groups, the expression level between the two groups was not statisticallysignificant (p>0.05).2RT-PCR products qualitative and semi-quantitative results The the experimental group LPAR3and HOXA11mRNA expression in endometrial implantation window enhanced gray value higher than control group (0.326±0.042,0.685±0.103,0.701±0.116, p<0.05;0.142±0.022,0.354±0.046,0.372±0.053, p<0.05), the difference was statistically significant, but the experimental groups, the expression level between the two groups was not statistically significant (p>0.05).3Western blotting results2experimental groups were the endometrium LPAR3and HOXA11mRNA protein is greater in the control group (0.971±0.125,0.992±0.0508,0.793±0.1230, p<0.05;0.909±0.080,0.947±0.283,0.800±0.433, p<0.05), the difference was statistically significant, but the experimental groups, the expression level between the two groups was not statistically significant (p>0.05).Conclusions1Endometrial curettage and Chinese medicine two interventions can make the endometrium LPAR3and HOXA11mRNA and protein expression increased in the implantation window.2Endometrial curettage and proprietary Chinese medicines two interventions can improve endometrial receptivity, improve the pregnancy rate. |
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