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目的:通过研究人着床窗期子宫内膜组织中溶血磷脂酸受体3(LPAR3)和肝素结合表皮生长因子(HB-EGF)及其mRNA的表达,进一步探索反复移植失败的原因。方法:选取胚胎反复移植失败(RIF)患者23例为实验组,同期初次接受体外受精-胚胎移植(IVF-ET)助孕即妊娠的患者31例为对照组,着床窗期(排卵后第6～7天)微创法吸取少量子宫内膜组织,采用免疫组织化学SP法和半定量反转录-聚合酶链反应(RT-PCR),检测子宫内膜组织中LPAR3和HB-EGF及其mRNA的表达,并收集相关临床资料。结果:LPAR3和HB-EGF及其mRNA在两组患者的子宫内膜中均呈阳性表达,两者在部位和特点上存在一致性。RIF组的LPAR3和HB-EGF的平均光密度值明显低于对照组(P<0.01),LPAR3和HB-EGF mRNA表达亦明显低于对照组(P<0.01)。RIF组患者年龄、FSH使用天数(天)和剂量(IU)均明显高于对照组(P<0.05),而血P(μg/L)水平明显低于对照组(P<0.01)。结论:LPAR3参与了人子宫内膜容受性的建立过程,随着患者年龄的增长而表达降低,与HB-EGF在表达部位和特点上存在一致性,可作为预测子宫内膜容受性的良好参考指标。着床窗期血P水平降低、子宫内膜组织中LPAR3和HB-EGF的低表达可能导致胚胎反复移植失败的发生。
OBJECTIVE: To further investigate the causes of repeated transplantation failure by studying the expression of LPAR3 and HB-EGF and their mRNA in the endometrial tissue during the implantation window. Methods: Twenty-three patients with failed embryo transfer (RIF) were enrolled in this study. Totally 31 pregnant women undergoing in vitro fertilization-embryo transfer (IVF-ET) during the same period were selected as the control group. The implantation window 6 ~ 7 days) minimally invasive method to absorb a small amount of endometrial tissue, the use of immunohistochemical SP method and semi-quantitative reverse transcription - polymerase chain reaction (RT-PCR) detection of endometrial tissue LPAR3 and HB-EGF and Its mRNA expression, and collect relevant clinical data. Results: The expression of LPAR3, HB-EGF and their mRNA in the endometrium of both groups were positive, and there was consistency in their location and features. The average optical density of LPAR3 and HB-EGF in RIF group was significantly lower than that in control group (P <0.01). The mRNA expression of LPAR3 and HB-EGF in RIF group was also significantly lower than that in control group (P <0.01). The age, number of FSH days and IU in RIF group were significantly higher than those in control group (P <0.05), while blood P (μg / L) level was significantly lower than that in control group (P <0.01). Conclusion: LPAR3 participates in the process of human endometrial receptivity, which is decreased with the age of patients. It is consistent with the expression of HB-EGF in the expression site and features, which can be used as a prediction of endometrial receptivity Good reference indicator. The level of blood P in the implantation window is decreased. The low expression of LPAR3 and HB-EGF in the endometrium may lead to the failure of repeated embryo implantation.