Research On The Relation Between Expression Of Endometrial TGF-β1and Estrogen Dose And Clinical Prognosis Of Intrauterine Adhesions

Objective:To observe the effect of various dose of estrogen therapy on the prognosis of intrauterine adhesion (IUA) and the expression of endometrial transforming growth factor beta1(TGF-(31)following adhesiolysis procedure. Secondarily, To observe the correlation between the expression of TGF-β1and the prognosis of IUA.Methods:Approximately90patients with moderate IUA underwent trans-cervical resection of adhesion procedure (TCRA) and were given estradiol valerate post-adhesiolysis for three menstrual cycles. All patients were randomly divided into3groups:Estrogen valerate3mg/day (Group1);6mg/day (Group2);9mg/day (Group3). None of the patient has undergone TCRA procedure before. Endometrial tissues near the adhesion site were obtained duing the first TCRA and the second look hysteroscopy (three menstrual cycles after the initial TCRA) for immunohistologically measurement of TGF-J31expression. All IUA were graded pre-and post-adhesiolysis according to the AFS scoring system.Results:1. Comparison of TGF-β1expression between pre-and post-adhesiolysis procedure:Pre-and post-adhesiolysis TGF-β1expression in all groups were significantly different (p<0.05).2. There were no significant differences of pre-adhesiolysis TGF-β1expression between groups. Postprocedurally, TGF-β1expression were found significantly higher in group3compared to group1and2(p<0.05). However the difference between group1and2was not significant (p>0.05).3. There were no significant differences of pre-adhesiolysis AFS score between groups. Postprocedurally, AFS score was significantly lower in group2and3compared to group1(p<0.05). However the difference between group2and3was not significant (p>0.05).Conclusion:1、Estrogen can upregulate endometrial TGF-β1expression in patients with IUA.2、Estrogen valerate with dose of6mg/d may be the most appropriate post-adhesiolysis dose for patients with IUA.