口服避孕药对高FSH不孕症患者子宫内膜容受性的影响

摘要

Objective: To explore the changes of endometrial receptivity in infertile women who were treated by oral contraceptive pills due to an elevated basal follicle stimulating hormone ( FSH). Methods; Fifteen infertile women with elevated FSH were administrated with oral contraceptive pills for three cycles. The endometrial biopsies were performed in the mid - luteal phase before ( group 1) and after (group 2) the therapy. The parameters of endometrial receptivity including the development of pinopodes and biochemical markers, e. g. leukemia inhibitory factor (LIF) , vascular endothelial growth factor (VEGF) , integrin (33, were compared. Results:All of 15 mid - luteal biopsies (100.0% ) were in - phase in group 2. However, only 9 out of 15 (60.0% ) of biopsies showed the in - phase endometria in group 1. The synchronization of endometrial development was significantly higher in group 2. The fully developed pinopodes rate was also higher in group 2 (57. 8% ) than in group 1 (35.6% , P < 0. 05 ). The mean LIF and integrin β3 levels were 2.41 ± 0.50 and 2. 39 ± 0.41 in group 2, significantly higher than 1.91 ±0.46 and 2. 10 ±0.26 in group 1 (P <0. 05). Conclusion; Oral contraceptive pills administration improved endometrial receptivity and synchronous development in women with elevated basal FSH.%目的:探讨口服避孕药治疗对基础卵泡刺激素(FSH)水平升高的不孕妇女子宫内膜容受性的影响.方法:收集基础FSH＞ 10U/L的不孕妇女15例,口服避孕药治疗3个月,比较治疗前后黄体中期子宫内膜的病理变化、胞饮突发育情况和子宫内膜容受性生化标记因子,包括白血病抑制因子(LIF)、血管内皮生长因子(VEGF)、基质金属蛋白酶9(MMP9)、整合素β3的表达水平.结果:治疗前分泌中期子宫内膜占60％ (9/15),治疗后全部内膜标本均显示分泌中期内膜,差异有统计学意义(P＜0.05).治疗前完全发育胞饮突率(35.6％)低于治疗后(57.8％)(P＜0.05).治疗前内膜腺体的LIF和整合素β3表达水平分别为1.91±0.46和2.10±0.26,低于治疗后的2.41 ±0.50和2.39±0.41 (P ＜0.05).结论:高FSH不孕患者口服避孕药治疗后子宫内膜发育的同步性得到改善,子宫内膜容受性增加.