Research Of Relationship Between ER,PR,HOXA-11and Control Failure Of IVF-ET

BackgroundIn vitro fertilization-embryo transfer(IVF-ET)and other assisted reproductive technology appears to make a revolutionary improvement on infertility treatment since the world’s first IVF birthes at1978, and becomes a final choice for infertility caused by a variety of factors.A factor determined various assisted reproductive technology success is the quality of embryonic development, another is endometrial receptivity to embryo,and endometrial receptivity is an important link to ensure that the fertilized egg implantation and fetal, placental development. Over the years, through controlled ovarian hyperstimulation (COH), laboratory techniques improved, the number and quality of embryos has been gradually optimization,while IVF-ET cycle control rate still hovers at around40%, so the research based on endometrial receptivity attracts attentions of scholars at home and abroad day by day.At present, the researchers from China and abroad have made a lot of research on the endometrial receptivity ability with various levels of the endometrial cell morphology, histology, molecular biology, but it still further research and evaluation on the feasibility of using these markers to guide clinical practice. Endometrial can secrete a variety of network-like&interacted cytokines, to adjust the endometrial microenvironment together in favor of the implantation of the embryo. Now the researchers from China and abroad researched a large number of small biomolecules including leukemia inhibitory (LIF), vaseu arenothe the ia growthafeto (VEGF), interleukin (IL), epiderma growthafetor (EGF), hemeobox genes-10(HOXA-10)&hemeobox genes-11(HOXA-11), integrins, etc. The studies showed that the above-mentioned factors play an important role in guiding the implantation of the embryo, so we monitored their changes as the markers to predict endometrial receptivity. It is till a popular thing to make an in-depth study on the related factors of endometrial receptivity and the mechanism of action of all relevant factors to find the factors affecting the control rate of IVF-ET.Research purposeWe discussed with endometrial receptivity decreasing the potential mechanisms after IVF-ET of infertile patients, explore the effect of in vitro fertilization and embryo transfer (IVF-ET) pregnancy rate related factor, for the formulation of improved endometrial receptivity, improve assisted reproductive success rate of intervention measures.Materials and methodsTake78patients conducting IVF-ET due to tubal factor infertility in Zhengzhou University The Third Affiliated Hospital Reproductive Center confirmed during2011March and2011July. Pumping PB of fasting patients and using chemiluminescence method to measure serum E and p levels within5-7days after ovulation during the natural cycle of assiting control (window phase of endometrial planting); and drawing a small amount of endometrial tissues of patients with minimally invasive method at that day, the tissues were divided into two parts, one parts were used for the semi-quantitative and positioning analysis on the expression of Endometrial epithelial and stromal ER, PR and HOXA-11with the organization integral H-score method and immunohistochemistry sp France, the other parts were used for the detection of endometrial expression of ER, PR and HOXA-11protein during planted window phase with reverse transcription and by polymerase chain reaction (RT-PCR). We divided the78cases of patients into control group (n=31)and experimental group (n=47) for comparison according to whether be pregnant after assisting.Result1. The control group and experimental group didn’t show statistically different in age, infertility years,body mass index, causes of infertility, type of infertility, the basal state (the first2-4days of the menstrual cycle), the follicle stimulatin ghormone (FSH), and luteotropic hormone(LH),E2level,blood E2level, of theplanting window, and endometrial thickness level,of theplanting window, and endometrial thickness, numberofoocytes, Gndosage.Compared with the control group, the difference was not statistically significant (P>0.05),3.The expression of ER is mainly in the nucleus, and the nuclear expression in endometrial epithelial and stromal cells were positive. The positive expression rates of Control group in endometrial epithelial and stromal cells were higher than non-pregnant group, but the difference was not statistically significant (1.46±0.21vs.1.43±0.23, P>0.05;1.27±0.20vs.1.25±0.20, p>0.05)4, Mainly expressed in the nucleus, the PR of pregnant group were negative or weakly positive expression in the glandular epithelium, strong positive expression in the interstitium. Non-pregnant group of PR expression in the glandular epithelium and stromal cells were positive. Control group expression rate in the glandular epithelium was significantly lower than non-pregnant group, the difference was statistically significant (0.61±0.14vs.2.59±0.22,P<0.001). The expression rate of control group in the qualitative was significantly higher than non-pregnant group, the difference was statistically significant (2.92±0.24vs.2.49±0.27,P<0.001)5, HOXA-11mainly expressed in cytoplasmic, control group HOXA-11was negative or weakly positive expression in the glandular epithelium, and strong in the interstitium. Non-pregnant group HOXA-11showed positive expression of the glandular epithelium and stromal. Control group expression in the glandular epithelium was significantly lower than non-pregnant group. The difference was statistically significant (120.55±14.85vs.150.44±12.68,P<0.001), Control group in the qualitative expression rate was significantly higher than non-pregnant group, and the difference was statistically significant (156.40±9.58vs.144.30±10.62,P<0.001).6, Analysis by20ml/L agarose gel electrophoresis, ER, PR and HOXA-11mRNA amplification products and the theoretical length were the same. The results show that ER purposes bands was at137bp, and the PR was at348bp, HOXA-11at265bp, β-actin at564bp。 Make Semi-quantitative determination, showing target gene relative expression levels with gray scale ratio of target gene and β-actin DNA bands. We got that in control group, all the expression of endometrial ER、 PR and HOXA-11mRNA, are significantly higher than non-pregnant group, and there was significant difference (0.48±0.03vs.0.11±0.01,P<0.001;0.62±0.06vs.0.38±0.05, P<0.001;0.36±0.02vs.0.16±0.01, P<0.001)Conclusion1. The reduction of Serum P caused the reduction of endometrial receptivity, and this is reason leading to the failure of IVF-ET control; the serum E level was no significant correlation with endometrial receptivity.2. ER showed positive expression in endometrial epithelial and stromal cells during the implanted window phase, the positive expression rate of it was no significant correlation with the endometrial receptivity. The positive expression rate PR in the glandular epithelium increased during the window phase while it presents an opposite result in mesenchymal cells during the window phase, this leaded the failure of control by IVF-ET.3. During the implanted window phase, the positive expression rate of HOXA-11in the glandular epithelium increased during the window phase while it presents an opposite result in mesenchymal cells, this leaded the failure of control by IVF-ET.