| Objective: To observe the effect of Erzhi Tiangui Granules(ETG) on endometrial reception and the temporal expression of endometrial beta3-integrin and its ligand osteopontin during peri-implantation in controlled ovarian hyperstimulation(COH) of mice,and explore the mechanism of Tranditional Chinese Medcine(TCM) nourishing the kidney in improving endometrial reception.Method: 64 infertil women undergoing In vitro Fertilization and Embryo Transfer (IVF-ET) were randomized into test group,treated with ETG and gonadotropin (Gn)(31 cases),and control group,treated with Gn only(33 cases),to evaluate the syndrome points of TCM,the dose and days of Gn,thickness and type of endometrium,pulsatility index (PI) and resistent index (RI) of uterous artery,endometrial blood stream,hormone level in serum,high-quality oocyte rate,fertility rate,high-quality embryo rate,implanted embryo rate and the clinical pregnancy rate of both. In empirical study,sex mature Kunming female mice were randomized into test group,treated with COH and ETG,control group,treated with COH only,and normal group. Obtain the endometrium on day 0,2,4,6,8 of pregnancy(Pd0,Pd2,Pd4,Pd6,Pd8) apart to detect the temporal expression of endometrial beta3-integrin and its ligand osteopontin messenger ribonucleic acid (mRNA)in the way of in situ hybridization (ISH).Results:Clinical study:There are statistical significance before and after the treatment in the syndrome points of Kidney-deficiency(P<0.05),type of endometrium,PI and RI of uterous artery,endometrial and under- endometrial blood stream on HCG day(P<0.05), and the clinical pregnancy rate(P<0.05)of two groups;while not in the thickness of endometrium, dose and days of Gn,hormone level on HCG day,high-quality oocyte rate, fertility rate,high-quality embryo rate and implanted embryo rate(P>0.05).Empirical study:1.The rule of expression of beta3-integrin and its ligand osteopontin mRNA on the peri-implantational endometrium of normol group mice: comparing to the low expression in non-pregnancy,it rised after pregnancy,topped on Pd4(i.e.the day of nidation) with statistical significance contrast with other time points(P<0.05)and decreased after that.The expression on Pd8 is still higher than that of non-pregnancy. 2.The rule of expression of beta3-integrin mRNA on the peri-implantational endometrium in control group:it was low in non-pregnancy,topped on Pd2 with statistical significance contrast with other time points(P<0.05)and decreased gradually according to the pregnancy and the expression on Pd8 is still higher than that of non-pregnancy.3.The rule of expression of osteopontin mRNA on the peri-implantational endometrium in control group: contrast with the low expression in non-pregnancy,it rised after pregnancy,topped on Pd4 with statistical significance contrast with other time points(P<0.05) and decreased gradually to a much lower level on Pd6 and Pd8.4.The rule of the temporal expression of endometrial beta3-integrin and its ligand osteopontin during peri-implantation in control group is similar to that of the normal group,the top was a little lower with no statistical significance.5.The expression of beta3-integrin mRNA of control group was obviously higher on Pd2,lower on Pd4 and Pd6 than normal group with statistical significance(P<0.05)and a little lower on Pd8 with no statistical significance(P>0.05).6.The expression of osteopontin mRNA was much lower in control group on Pd4,Pd6 and Pd8 than normal group with statistical significance(P<0.01).7.The temporal expression of osteopontin mRNA and beta3-integrin mRNA in normal group and test group are of positive correlation,the top expression and curve fitting of both are in concordance;while the osteopontin mRNA and beta3-integrin mRNA in control group have no correlation,and the top expression and curve fitting of both are in no concordance.Conclusions: 1.The use of ETG in the COH of IVF-ET can improve syndroms of kidney-deficiency, increase blood supply of endometrium, ameliorate endometrial reception, raise the clinical pregnancy rate with no effect on the clinial COH.2.The expression of endometrial beta3-integrin and its ligand osteopontin during peri-implantation have high concordance in time,and the coordination of the two can be used as one marker of the endometrial reception.3.COH may have some effect on the temporal expression of endometrial beta3-integrin mRNA and its ligand osteopontin mRNA during peri-implantation , it can bringing forward the top of endometrial beta3-integrin expression,broke the inner coordination of beta3-integrin and its ligand osteopontin thus affected the establishment of endometrial reception.4.TCM nourishing the kidney can regulate the expression of endometrial beta3-integrin and its ligand osteopontin to improve endometrial reception in COH.5.Provide evidence for the application of TCM in IVF-ET. |
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