Endometrial Integrin Expression In Women Undergoing In Vitro Fertilization And Embryo Transfer And The Association With Subsequent Treatment Outcome

With the development of in vitro fertilization and embryo transfer (IVF-ET). One of the main goals has been to improve its overall success rate. The progress of embryo implantation is very complicated. Favorable state of endometrium and the synchronization with embryo are the main factor to improve the pregnancy rate. Integrins are a group of cell adhesion molecules. They are composed of heterodimeric alpha and beta. It involved in the adhesion and information transmitting between cell and cell or cell and substratum. In human endometrium, integrin β3 is peculiarly expressed in the "implantation window"(7-10 days after ovulation) and relates with multiform infertility. Now it is regarded as a new reliable marker of uterine –embryo receptivity (EER). Objective: To study the endometrial expression of integrinβ3 in women undergoing IVF-ET, and discuss its relation with subsequent treatment success. Methods: Use the immunohistochemistry methods to determine the location and intensity of integrinβ3 staining in endometrium during 7-10 days after ovulation(cycle day 21-24) from 33 cases undergoing IVF-ET (infertility group ) and 9 normal women ( control group ). The clinical date analyed by t,test and Binary logistic regression. The ordinal date is analyed by rank sum tes(tWilcoxon method).Categorical date analyed by Exact Sig test . Result: 1.Immunolocalization of integrinβ3 were observed mainly in cytoplasm of luminal epithelium and glandular epithelium. Little expression in stromal cells. 2. Ultimate pregnancy rate is 21.2%. There were no qualitative difference between pregnant group and nonpregnent group in Mean age,Basic endocine level,No.of ovums fetched,Fertilization rate,No.of embryos transferred,embryo score,thickness and type of endometrium on transfer day,Mean cycles of IVF-ET(P>0.05). The expression of integrinβ3 in endometrium was significantly elevated in pregnant group and control group(P<0.05)compared with nonpregnant group. However, there were no difference between pregnant group and control group. 3. In 33 cases, 17 case were secondary infertility ,16 cases were primary infertility. All pregnant cases were secondary infertility. None of primary cases is pregnant. The expression of integrinβ3 was significantly elevated in secondary infertility group(P<0.02)compared with the primary infertility group. 4. Analysed all the clinical date use Logistic regression,found the higher the fertilization rate is, the higher the last pregnant rate is (P=0.06). Conclusion: The endometrial expression of integrinβ3 may influence the ultimate pregnant rate of IVF-ET. Long year's primary infertility patients have low pregnant rate after IVF-ET, mainly because of the absence of integrinβ3 in endometrium.