| BackgroundRecurrent spontaneous abortion (RSA) has intricate pathogenic factors and endometrial receptivity(ER) is the most important factor. Most of RSA show early abortion. Pinopode has surely significance in evaluating endometrial receptivity and the symbol of implantation window. Human chorionic gonadotropin (hCG) could promote vascularization on the maternal-fetal interface, enhance immune tolerance, make for embryo invasion. Moreover, hCG could enhance endometrial receptivity by delaying endometrial decidualization and extending endometrial implantation window. This experiment takes RSA patients as research objects; analyzes endometrial receptivity and earlier abortion rate of recurrent spontaneous abortion patients after intrauterine infusion hCG in ovulation.ObjectiveObserve development of endometrial pinopode of RSA patients after intrauterine infusion hCG under scanning electron microscope (SEM). Analyze the contact of endometrial pinopode’s growth and estradiol (E2), progesterone (P). Discuss the influence of earlier abortion rate of RSA patients after intrauterine infusion hCG besides different scenarios of luteal support.Methods1.88RSA patients (Lost9cases) are randomly divided into3groups:control group (n=29), research groupl (n=25) and research group2(n=25). Research group1and2all accept intrauterine infusion hCG500IU every menstrual cycle,2days before ovulation and the day of ovulation each time. Control group is without any processing in ovulation period.2. At the first menstrual cycle, all groups draw a little of endometrial tissue after ovulation6-8days for observing with SEM. Pumping venous blood of fasting patients3ml and measure serum E2and P,3. At the second, third and fourth menstrual cycle, all groups make guidance intercourse in ovulation and give progesterone capsules100mg bid po last16days after ovulation. Measure hCG after drawing blood to confirm the gravidity. Positive pregnancy patient: control group and research group1make progesterone injection intramuscular injection by20mg qd lasting pregnancy12weeks; research group2give progesterone injection20mg qd im and Le-yun-ning oral liquid10ml tid oral to12weeks of gestation.Results1. There were no significant differences (P>0.05) among the age, times of abnormal gestation and endometrial thickness (ovulation day) of three groups.2. At the first menstrual cycle, E2level of the three groups were no significantly difference (P>0.05). There were statistically significant difference (P<0.05) in P level among the research group1(25.44±2.35ng/ml) and the research group2(26.45±2.94ng/ml) compared with control group (19.87±4.45ng/ml).Research group1, group2mature pinopode expression rate were68.00%,64.00%and there were statistically significant (P<0.05) compared control group.3.16days later, the number of β-hCG positive of research group1was11, research group2was12and control group was11. There were no significant differences (P>0.05) among the three groups of pregnancy rate.6weeks after pregnancy, compare with control group, serum P level showed statistically significant (P<0.05) in research group land2. Pregnancy12weeks later, the abortion rate of research group1was18.18%, research group2was0.00%and control group was36.36%. Abortion rate of research group1and2were lower than control group. Statistically significant could be found in research group1compared with control group (P<0.05).Conclusion1. The RSA patients’pinopode is hypogenetic during the implantation window, intrauterine infusion hCG can make the number of mature pinopode increased.2. Intrauterine infusion hCG in ovulation and giving progesterone when pregnancy could reduce the early abortion rate effectively compared with giving progesterone only in RSA patients.3. Intrauterine infusion hCG in ovulation with progesterone and using progesterone and Le-yun-ning oral liquid after gestation could be more safely and effectively prevention and treatment early abortion. |
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