Mechanism Research Of Decreased IL-10 Damaging Adenomyosis Infertility Patients Uterine Endometrial Receptivity

Object:To review the impact of adenomyosis on the clinical outcome of patients undergoing in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)cycle.To investigate the expression of IL-10 and HOXA10 in the endometrium of women with adenomyosis,and to explore their relationship.Research Methods:1.To collect clinical data and analyze the impact of adenomyosis on controlled ovulation and clinical pregnancy outcome in IVF/ICSI cycle from January 2009 to December 2015(Group A:adenomyosis women with long pituitary down-regulation;Group B:adenomyosis women with long pituitary down-regulation;Group C:tubal asoociated-infertile women with long pituitary down-regulation).2.The expression of IL-10,HOXA-10,STAT3 and p-STAT3 in the endometrium were examined by means of western blot and immunohistochemistry and correlation among these factors were also analyzed.3.The expression of HOXA10 and p-STAT3 protein of Ishikawa cell treated with rIL-10 or p-STAT3 inhibitor was examined by western blot.The attachment rate of JAR cell spheroid to Ishikawa cell was expressed as a percentage of the total number of spheroids.Results:1.There was no statistically significant difference between the three groups of age,infertile years,basal FSH level and antral follicle count.Clinical pregnancy rate,delivery rate and embryo implantation rate were respectively as below:62.5%,50.5%,68.4%(Group A);51.1%,35.6%,58.5%(Group B);43.5%,34.4%,49.5%(Group C).All these results of group C were higher than group A and B(P<0.05).The results of group A were higher than group B(P<0.05).2.The expressions of HOXA10(P<0.001)and IL-10(P<0.001)in the adenomyosis group were significantly lower than in the control group,and there was a positive correlation between HOXA10 and IL-10 protein level in all of women examined(r=0.47,P<0.05).The expression of p-STAT3 in the adenomyosis group was significantly lower than in the control group,and there was a positive correlation between IL-10 and p-STAT3 protein level in all of women examined(r=0.52,P<0.05).3.rIL-10 increased HOXA10 expression in a concentration and time dependent manner by inducing phosphorylation of STAT3 in Ishikawa cells.Treatment of rIL-10 promoted the attachment rate of JAR spheroid to Ishikawa cells,which was reversed by the inhibition of phosphorylation of STAT3.Conclusions:Uterine adenomyosis inhibits embryo implantation in patients who are involved in IVF/ICSI cycle.There is a positive correlation between levels of IL-10 and HOXA10 expression in the endometrium,both of which are significantly reduced in women with adenomyosis compared with fertile control women.IL-10 improves embryo implantation by up-regulating HOXA10 expression via STAT3 phosphorylation.