| As one of the most common diseases, infertility account for about 10-25% of incidence rate among couples. Even undergone through investigation, there are still 10% of them could not find the cause of their failure to conceive unexplained infertility. Among variety reasons, the failure of implantation becomes an important cause of consideration.Embryo implantation involve a series cells or biologic events. A rigid period is required for the endometrium receive the embryo when the synchronized development exist between embryo and endometrium. Recent studies in the factor that participate and modulate the process of peri-implantation have revealed that diminished receptivity caused by the disturbance of the endometrial lacal modulator factors, resulting in failed of defective embryo implantation is a mechanism that may account for the unexplained infertility.The MMPs form a family of structurally related, zinc-dependent endopeptidases that are involved in the degradation of the extracellular matrix (ECM) and basement6membranes (BM). These enzymes and their inhibitor TIMPs play a critical role in normal tissue-remodeling processes, including embryonic growth, development and implantation . Among MMPs, the 92-Kda type IV collagenase (MMP-9, gelatinase B) is a very important enzymes for BM degradation, capable of degrading virtually all components of the ECM, such as collagens, proteoglycans, and glycoproteins. MMP-9 degrades a variety of substrates, but particularly collagen type IV and V. Many studies have found that MMP-9 in glandular epithelial cells of endometrium was greatest during the late proliferative phase and just after ovulation; its presence in glandular secretion and the uterine fluid was optimal during the peri-implantation phase. It is possible that this enzyme might be functional in processing specific components of the uterine fluid, thereby contributing to the recognition processing required for blastocyst implantation.TIMPs are the natural inhibitors of all MMPs called tissue inhibitors of metalloproteinases of which four have been described. The TIMPs bind with high affinity and 1:1 molar ratio to active MMPs resulting in the loss of proteinase activity. TIMP-1 is the main inhibitor of MMP-9. The secretion of TIMP-1 are increased during peri-implantation phase accompaning with secretion of MMP-9. The TIMP-1 which can inhibit the activity of the MMP-9, are important regulators of ECM remodeling, and can limit the extent of trophoblast invasion. It is important for normal embryo implantation. The relevance between endometrial MMP-9/TIMP-1 and unexplained infertility have not been reported so far.In this study, 18 patients with the diagnosis of unexplained infertility were designated to the study group. The mean duration of their infertility was 3.33?.72 years (range 2-13 years). Of these patients fourteen had primary infertility and four had secondary infertility. Fifteen women with normal fertility were selected as fertilie controls. Measument of7BBT daily was requested, ovulation was considered to have occurred when there was a temperature rise of !>0.5癈, for ^12 days immediate preceding a menstruation period. Six to nine days after the onset of BBT ascending, venous blood samples were collected and the endometrial biopsies were performed. The blood serum and the tissue were both stored at the -80 *C. Serum ? and P were measured by specific R1A. The SP immmunohistochemical techniques with the monoclonoal antibody for the MMP-9, TIMP-1 and PR were performed on paraffin wax sections. Routine HE staining was accomplished in all women. Immunostaining outcome was semi-quantified by the H-Score. The purpose of this study was to investigate the immunohistochemical localization of MMP-9, TIMP-1 in mid-secretary phase of endometrium and to compare staining intensity of which between the infertile group and the control group, and than to discuss the significance in the disturbance of the locally endometrial factors on the pathogenic mechanism of infertility and further to conf... |
PDF Full Text Request