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The Expression of Integrin β3and Vascular Endothelial Growth Factor in the Thin Endometrium of the Implantation Window Period

Author: ZhangYingYing
Tutor: SuYingChun
School: Zhengzhou University
Course: Reproductive Medicine
Keywords: endometrial receptivity integrin β3 vascular endothelial growth factor thinendometrium implantation window period
CLC: R714
Type: Master's thesis
Year: 2012
Downloads: 138
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Abstract


BackgroundSince the in vitro fertilization and embryo transfer technology brought to the world the first case of test-tube baby, assisted reproduction technology has already get more and more attention. The emergence of the laboratory technology and development, make embryologists in fine embryo adoption and provide high quality of patients with embryos, but the average success rate test-tube baby is still around50%, and closely related with the pregnancy of endometrial let were uterine receptivity is embryo implantation of another important factors. Research shows that the normal state of endometrial in a very short period of time on embryos have accept ability, through to the endometrial tissue the morphology of the study found that this time to appear in the peak LH of6~10d, the menstrual20~24d, called "implantion period"Generally, in a certain range the endometrial thickness has the receptivity, under a critical value the pregnancy rate would reduce greatly. The school ar believe that endometrial secretion corpus luteum middle period thickness above8mm pregnancy rate increase greatly. The corpus luteum mid-term endometrial thickness8mm than the defined as thin endometrial, so it needs to explore the cause of thin endometrim thin mechanism to guide clinical drug use. Endometrial growth is a necessary condition of angiogenesis, this process is primarily by VEGF regulation, endometrial planting window period of VEGF expression in vascular level reflects the endometrial let were uterine receptivity. And integrin β3as recognized endometrial let were uterine receptivity mark one of molecules, also had many scholars’ attention. At present integrin β3the insemination, embryo implantation, embryonic development research is increasingly perfect. But the integrin β3and endometrial thickness less relationship. This study through the research of zhengzhou university first affiliated hospital of reproductive medicine center endometrial too thin (intima thickness than8mm) patients implanted window endometrial VEGF and integrin β3in the positioning of the endometrium and expression, preliminary explanation endometrial thickness and VEGF and integrin β3, the relation between the research to improve the endometrial thickness to improve endometrial let victims of uterine receptivityual and new methods to improve the assisted reproductive technology provide clinical pregnancy rates and research to provide the theory basis.ObjectiveTo investigate the angiogensis and expression of VEGF and integrin β3in the thin endometrium of implantation window.Explore the relationship between endometrial thickness and VEGF and integrin β3.Materials and methodsSelect27patients who had prepared to accept the treatment of IVF-ET/ICSI-ET/Thaw-ET during November2011to December2011in the first affiliated hospital of zhengzhou university reproductive centert.The into the standard:age25to35years old; study was before based endocrine normal; ultrasonic testing ovulation normal;infertility factor not the man or woman factors tubal factors (except hydrosalpinx);the end time during pregnancy or abortion did not accept such as after GuaGong endometrial biopsy; hysteroscopy auxiliary examination confirmed uterine form normal, no uterine deformity, endometrial polyps;nearly three months without hormone drugs take history. According to the middle and implanted window corpus luteum endometrial thickness will patients into the experimental group and control group, the endometrial thickness than8mm, patients endometrial thickness>8mm. The electrochemical luminescence method to detect injection take lining, serum Estradiol(Estradiol,E2), Progesterone (Progesterone,P).Vaginal two-dimensional ultrasound monitoring ovulation, ovulation on that day for day1,6days after ovulation for lining, biopsy. The electrochemical luminescence method to detect injection take lining, serum Estradiol (Estradiol, E2), Progesterone (Progesterone, P). Biopsy uterine cavity operation with patients before signing informed consent, take endometrial before the peep exposure, the cervix, with saline water flushing vagina, with one-time uterine tube organizations attract from endometrial tissue, from the body endometrial with saline water is rinsed clean, a more than4%in together with formaldehyde fixed, ready to paraffin, slice, HE after dyeing application immunohistochemistry methods detection of vascular endothelial growth factor and integrin β3in planting window endometrial positioning and expression, also a put95%alcohol fixed for pathologic examination. The SPSS17.0statistics software was used to the experiment data statistics analysis.Results1. Integrin (33in planting window endometrial cavity epithelial and glands tested positive in expression, is located in the plasma cells, a homogeneous shape tan. The control group integrin (33in the lining of the uterus is significantly below the expression (OD value145.84+/-3.32vs93.70+/-2.91), the difference was statistically significant (P<0.05).2. VEGF in the lining of the uterus glandular epithelium cells, mesenchymal cells and endothelial cells in the cytoplasm are expressed, with glandular epithelium cells express obvious. The control group of vascular endothelial growth factor expression in the lining of the uterus is significantly below the experimental group (OD value77.57+/-16.830vs118.67+/-16.440difference was statistically significant (P<0.05).3. Two groups of VEGF and integrin β3express positive correlation exists each (r=0.625, P=0.040; r=0.595, P=0.015). Two groups of endometrial thickness respectively with the integrin (β3existence is related with each (r=0.901, P=0.000; r=0.816, P=0.000). Two groups of endometrial thickness respectively with the existing VEGF is related with each (r=0.698, P=0.017; r=0.812, P=0.000). Endometrial thickness and VEGF and integrin (33existence is related with each (r=0.780, P=0.000; r=0.746, P=0.000). VEGF and integrin (33in the lining of the uterus is related with existing expression (r=0.908, P=0.000)Conclusion1. Thin endometrial implanted window period of vascular endothelial growth factor expression drop may be contributing to poor endometrial receptivity.2. The expression of integrin β3and vascular endothelial growth factor drop may related to thin endometrial.3. Integrin (33and vascular endothelial growth factor expression of a positive correlation.Further research on the mutual relationship should carry on.

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