Effect of warming acupuncture on uterine blood perfusion in patients with failed high-quality freeze-thawed embryo transfer / 中国针灸

OBJECTIVE@#To observe the effect of warming acupuncture on uterine blood perfusion in the patients with failed high-quality freeze-thawed embryo transfer (FET) and explore its effect mechanism on the improvement of clinical pregnancy rate after re-tranfer.@*METHODS@#A total of 72 patients of failed high-quality FET were randomized into an observation group and a control group, 36 cases in each one. In the observation group, after the menstrual period ended, warming acupuncture started at the acupoints located on the abdomen, e.g. Qihai (CV 6), Guanyuan (CV 4), Zhongji (CV 3) and Qugu (CV 2) and those on the lumbar sacral region, e.g. Shenshu (BL 23), Mingmen (GV 4) and Yaoyangguan (GV 3), 50 min in each treatment, once daily, at the interval of 1 day after 4-day treatment. The treatment was discontinued till the patients were at the ovulatory stage. In the control group, capsules were taken orally and continuously after the end of menstrual period, 3 capsules each time, three times a day and stopped at the ovulatory stage. The treatment of one menstrual cycle was taken as one course and the treatment for 3 menstrual cycles was required. Before and after treatment, the uterine artery pulsation index (PI), endometrial thickness, endometrial type, uterine blood perfusion, the recovery time of sufficient uterine blood flow, the endomentrial receptivity (ER) during the implantation window period and the clinical pregnancy rate were observed in the two groups.@*RESULTS@#After treatment, the endometrial thickness was increased and PI decreased obviously in the two groups (<0.05) and PI in the observation group was lower than that in the control group (<0.05). After treatment, the proportion of type a and type A of endometrium was increased markedly in the two groups (<0.05) and the proportion in the observation group was higher than the control group (<0.05). After treatment, the case proportion of sufficient uterine blood flow was increased obviously in the two groups (<0.05) and the value in the observation group was higher than the control group [83.3% (30/36) vs 69.4% (25/36), <0.05]. After treatment, the proportion of ER during the implantation window period was increased remarkably in the two groups (<0.05) and the value in the observation group was higher than the control group [72.2% (26/36) vs 50.0% (18/36), <0.05]. The recovery time of sufficient uterine blood flow in the observation group was shorter than the control group (<0.05) and the clinical pregnancy rate was higher than the control group [47.2% (17/36) vs 33.3% (12/36), <0.05].@*CONCLUSION@#Warming acupuncture enhances uterine blood perfusion and improves uterine endometrial receptivity so that the clinical pregnancy rate is increased after re-transfer in the patients with failed high-quality freeze-thawed embryo transfer.

Cellular homeostasis, implantation window and unexplained infertility: role of phosphatase and tensin homolog deleted on chromosome 10

Background: Balance between endometrial cell proliferation and apoptosis is crucial for successful embryo implantation. PTEN (phosphatase and tensin homolog deleted on chromosome 10), a pro-apoptotic factor, is proposed to be one of the signaling proteins through which estrogen and progesterone act to affect cellular homeostasis. Although reports in literature have suggested role of PTEN in regulating endometrial cell proliferation and apoptosis during window of implantation, its involvement in women with unexplained infertility is not clear. In the present study, we examined expression, cellular distribution and activation status of PTEN, cell proliferation, and apoptosis in midsecretory endometrium from women with unexplained infertility as compared to fertile controls.Methods: Endometrial biopsies from infertile (n=11) and fertile women (n=22) were used for immunohistochemical evaluation of PTEN, phospho-PTEN and Ki67. Terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling assay was performed for detection of apoptotic cells.Results: Biopsies from infertile women as compared to fertile controls demonstrated statistically significant: i) decrease in nuclear PTEN (P < 0.001), increase in nuclear phospho-PTEN (P < 0.05), increase in nuclear and cytoplasmic phospho-PTEN/PTEN ratio (P < 0.001 and P < 0.05 respectively) in endometrial stroma, ii) increase in cytoplasmic phospho-PTEN (P < 0.001) and phospho-PTEN/PTEN ratio (P < 0.05) in glandular epithelium (GE), iii) increase in Ki67 labeling in GE (P < 0.01) and stroma (P < 0.05) and, iv) decrease in (P < 0.001) apoptosis.Conclusions: Altered PTEN expression and associated modulation in cellular homeostasis during the implantation window might contribute to mechanism underlying unexplained infertility.

Interaction between endometrium and embryo under the condition of in vitro co-culture during the implantation window stage / 实用医学杂志

Objective To investigate the interaction between endometrium and embryo under the co-culture condition during the planting window stage. Methods Twenty patients who cancelled transplant for OHSS in the Reproductive Center of the second affiliated hospital of Zhengzhou university were enrolled.The discarded embryos were used to build the embryos co-culture system (Group A), with a single membrane (group B) and a single embryo(group C)as the control group. Levels of LIF and IGF expression and embryo growth were checked on 3, 4,5,6,7 day post-oocyte retrieval. Results Expressions of LIF mRNA and IGF mRNA in Group A were significantly higher than those in Group B. Embryo growth in the Group A was better than that in Group C. Conclusion Co-culture of endometrium and embryo supports the development of embryo and improves the receptivity of endometrium.

Study on correlation of implantation window phase effect of uNK on angiogenesis and uterine artery blood flow and embryo implantation / 中国免疫学杂志

Objective:In vitro fertilization and embryo transplantation in patients with endometrial implantation window phase of natural killer cell ( uNK ) influence on the endometrial microvascular and uterine artery pulsatility index and embryo implantation.Methods:A retrospective analysis of our hospital from January 2009 to July 2013 the implementation of in vitro fertilization and embryo transfer(IVF-ET) clinical data of 37 patients,according to whether the success of pregnancy and at least 2 times for IVF-ET failure into success group(26 cases)and the failure group(11 cases),compared two groups of research object during the window of implantation in the uterus endometrial uNK cell marker CD56+, uterine artery pulsatility index, vascular endothelial marker F8 factor,alpha smooth muscle actin( alpha SMA) and myosin heavy chain( SMM) and the relationship between the expression of difference.Results:Success group based FSH 3.52±0.68(mU/ml),basal antral follicles of 9.44±2.53 compared with the failure group differences were not statistically significant(P>0.05).The successful group of uNK cells of 27.18±5.94(%),MVD 6.79±1.74 (%) ,αSMA 33.72 ±4.19 (%) , SMM 25.19 ±5.83 (%) were significantly higher than the expression rate of IVF-ET assisted reproductive failure group(P0.05).Conclusion:During the window of implantation in the endometrium of natural killer cells and endometrial angiogenesis was significantly associated with successful pregnancy, may have a certain relationship;uterine artery PI and pregnancy outcome successful has no obviously relationshhip.

Histochemical study of early embryo implantation in rats / Estudio histoquímico de la implantación temprana en ratas

Embryo implantation is the process that results in attachment of the conceptus to the uterine wall. In this histochemical study, we investigated the early stage of embryo implantation in rats by morphological analysis and by the detection of total proteins and glycosaminoglycans using hematoxylin-eosin, toluidine blue at pH 4.0 (TB), and Xylidine Ponceau at pH 2.5 (XP). In non-pregnant females, the uterine layers could be clearly distinguished and showed the normal histology of the organ. In pregnant females, an increase in the number of cells and a reduction in the interstitial space were observed in the endometrium close to the implantation sites. The blastocyst was partially inserted in the endometrium, with the observation of the inner cells mass around the blastocyst cavity surrounded by trophoblastic cells. TB staining revealed mild metachromatic basophilia, which was more evident in the endometrial stroma around the implantation site. Histochemical staining with XP was also more intense in the stroma close to the site of implantation. On the other hand, histochemical staining with either TB or XP was more discrete at sites distant from the conceptus. This study demonstrated changes in the endometrial stroma in areas adjacent to the site of embryo implantation, with variations in glycosaminoglycans and proteins as demonstrated by the detection of anionic and cationic radicals, respectively.

La implantación embrionaria es el proceso que resulta en la unión del embrión a la pared uterina. En este estudio histoquímico, se determinó la fase inicial de implantación del embrión en ratas mediante el análisis morfológico y por la detección de proteínas totales y glicosaminoglicanos con hematoxilina-eosina, azul de toluidina a pH 4,0 (TB) y xilidina Ponceau a un pH de 2,5 (XP). En las hembras no preñadadas, las capas del útero pueden ser claramente distinguidas y mostraron la histología normal del órgano. En las hembras preñadas, se observa un incremento en el número de células y una reducción en el espacio intersticial del endometrio para cerrar los sitios de implantación. El blastocisto se implanta parcialmente en el endometrio, con presencia de masa de células internas en torno a la cavidad del blastocisto, rodeado por las células trofoblásticas. La tinción TB reveló leve basofilia metacromática, lo cual fue más evidente en el estroma endometrial alrededor del sitio de implantación. Tinción histoquímica con XP también fue más intensa próximo del estroma en el sitio de implantación. Por otro lado, la tinción histoquímica, ya sea con la tuberculosis o XP fue más leve en los lugares distantes del embrión. Este estudio demostró cambios en el estroma del endometrio en las zonas adyacentes al sitio de la implantación del embrión, con variaciones en glucosaminoglicanos y proteínas, como lo demuestra la detección de radicales aniónicos y catiónicos, respectivamente.

Hormonal regulation of uterine chemokines and immune cells / 대한생식의학회지

The ultimate function of the endometrium is to allow the implantation of a blastocyst and to support pregnancy. Cycles of tissue remodeling ensure that the endometrium is in a receptive state during the putative 'implantation window', the few days of each menstrual cycle when an appropriately developed blastocyst may be available to implant in the uterus. A successful pregnancy requires strict temporal regulation of maternal immune function to accommodate a semi-allogeneic embryo. To preparing immunological tolerance at the onset of implantation, tight temporal regulations are required between the immune and endocrine networks. This review will discuss about the action of steroid hormones on the human endometrium and particularly their role in regulating the inflammatory processes associated with endometrial receptivity.

Expression of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 protein in the implantation window phase of endometrium in ovulation normal women / 重庆医科大学学报

Objective:To study the expression of matrix metalloproteinase-9 (MMP-9)/tissue inhibitor of metalloproteinase-1(TIMP-1) protein in the implantation window endometrium phase in ovulation normal women and the role of MMP-9/TIMP-1 on embryo implantation.Methods:SEM was used to determine “implantation window” of the mid-secretive phase endometrium in ovulation-normal women.Immunohistochemical analysis was applied to measure the expression of MMP-9/TIMP-1 protein in the implantation window in 15 cases,and MMP-9/TIMP-1 expression in endometrium during different phases were compared.Results:MMP-9/TIMP-1 expression in endometrium was observed in luminal,glandular epithelium and stromal cells in different phases.The expression was lower in proliferative phase,and got to the summit in the implantation window and late secretive phase and it expressed significantly higher in the implantation window phase(P