【摘要】 目的对不明原因不孕患者着床窗期子宫内膜容受性进行评价。方法对2005年10月至2008年8月在广东省计划生育专科医院就诊的71例不明原因不孕患者和16例正常生育妇女在着床窗期行阴道超声、宫腔镜检查及内膜活检,扫描电镜观察胞饮突,宫腔冲洗液和血清Glycodelin水平测定,子宫内膜白血病抑制因子(LIF)及血管内皮生长因子(VEGF)测定,两组进行分析比较。结果不孕组排卵期、着床窗期超声内膜厚度[(0.93±0.12)cm、(1.02±0.10)cm]均较正常生育组[(1.06±0.10)cm、(1.16±0.08)cm]薄(P<0.01),排卵期A型内膜比例(45.07%)较正常生育组(81.25%)显著减少(P<0.01)。宫腔镜下不孕组佳型内膜比例(18.31%)明显少于正常组(81.25%)。不孕组内膜发育不同步,子宫内膜胞饮突所占面积不足,且胞饮突的发育明显滞后于正常组。不孕组宫腔冲洗液glycodelin含量(116.34 ng/mL)较正常组减少(196.23ng/mL)(P<0.05),子宫内膜中VEGF和LIF的表达均弱于正常组(P<0.05)。结论着床窗期子宫内膜容受性欠佳,胚胎着床障碍可能是妇女不明原因性不孕的主要原因之一。更多还原

【Abstract】 Objective To evaluate the endometrial receptivity in the implantation window of the unexplained infertile women from three aspects such as endometrial morphology,cytokine and secreted protein.Methods 71 women with unexplained infertility and 16 normal women were examined in the implantation window,including vaginal B-typed sonography, hysteroscopy and endometrial biopsy,pinopode by scanning electron microscope,the level of glycodelin in uterine fluid and the serum,leukemia inhibitor factor(LIF) and vascular endothelial growth factor(VEGF) expression in the endometrium.Results The endometrial thickness in ovulation and implantation window of unexplained infertile women [(0.93±0.12) cm,(1.02±0.10) cm]was thinner than that of the normal women[(1.06±0.10) cm,(1.16±0.08) cm](P<0.01),and the proportion of A-typed endometrium in ovulation of infertile women(45.07%) was also lower than that in normal women(81.25%)(P<0.01).The proportion of‘good’endometrium under hysteroscope in infertile women(18.31%)was significantly lower than that in normal women(81.25%).Compared with the normal women,the endometrium in infertile women demonstrated asynchronous development,and the pinopode coverage was deficient,and the pinopode development was delayed.The level of glycodelin in uterine fluid of infertile women(116.34 ng/mL) was lower than that of normal women(196.23 ng/mL)(P<0.05).The expression of LIF and VEGF in infertile women was weaker than that of normal women(P<0.05).Conclusion The endometrial receptivity deficiency and embryo-endometrial asynchrony may be one of the major causes of unexplained infertility.更多还原