Research On The Relationship Between Endometrial Pinopodes And The Level Of Estrogen And Progesterone In The Ovulation Induction

BackgroundControlled ovarian stimulation,as a common assisted reproductive technology,mainly uses drugs to promote the development of female follicles and produces more than one egg cell.It is usually used to treat female infertility.Many researchers have attempted to determine whether a significant change would appear in the endometrial implants under controlled ovarian stimulation cycles,and this problem can be studied by using endometria of the person who provides eggs.By using scanning electron microscope,a significant change in the process of the endometrial epithelium in this period was obtained.However,the research on how hormones regulate the formation of cytoplasmic processes,the development of the cytoplasmic membrane and the estrogen and progesterone receptors in the endometrium is not enough.ObjectiveTo investigate the law of natural change of pinopode under the condition of COH?controlled ovarian hyperstimulation?cycle and the relationship between pinopode and the estrogen?E2?,progesterone?P?and their corresponding receptors and the value of E2/P during the period of COH cycle.Methods1.45 healthy volunteers were selected and divided into 2 groups.The experimental group?30 healthy volunteers?was treated with COH.The control group?15 healthy volunteers?is the natural cycle group.2.Endometrium was collected at0-14^th day after ovulation with the interval of 24-72h.After rinsing with normal saline,divided the tissue into two parts one wasprepared for tissue slice.HE staining was used for histological stage.After that,immunohistochemical staining.The other one was used to make specimen for SEM and to observe the development of the pinopode of the endometrium3.Pumping PB of fasting patients with 3 ml and using fluorescent magnetic particles ELISA method to measure serum estrogen and progesterone.Testing the concentration of estrogen and progesterone on the 12^th day?the day injected HCG?in the menstrual cycle and analyzing estrogen/progesterone ratio statistically.Result1.There were 9 cases of mature cell apoptosis,which were observed in the scanning electron microscope?SEM?.Among them,there were 8 cases in the mid secretory endometrium,which accounted for 88.89%,and the other one in the early secretory phase.2.The time of the occurrence of pinopodes was 2 days ahead in COH cycles compared to the natural period.The occurrence of pinopodes in COH cycles is generally the 19^th day of the menstrual cycle,while the occurrence of pinopodes under the natural condition is the 21^st day in the menstrual cycle.3.The significant differences appeared in the time of the occurrence of full developed pinopodes of different individuals during the COH period.The main periods of the occurrence of full developed pinopodes in COH cycle appeared in 4-6^th day after ovulatioin,and the time range was 5 days.Under the natural cycle,the corresponding time is 20-22^nd,and the time range is 3 days.4.The average value±standard deviation of E2/P of peripheral blood HCG day in COH cycles was 2321.06±886.42,while the corresponding value in natural ovulation group was 102.56±56.43.Statistical difference is obvious between these two groups?P<0.05?.5.The expression of PRs and ERs in the natural cycle was decreased in 6^th day and 4^thh day respectively after ovulation,while the expression of PRs and ERs under the COH cycle was declined in 4^th and 2^th respectively after the egg.6.The concentration of P in the day before the egg is taken in the peripheral blood for the pinopodes appeared before 5^th day was 5.47±1.13 ng/ml,while the corresponding value was 7.13±0.83 ng/ml for the pinopodes appeared after 5^th day.Conclusion1.The mature pinopode was mainly appeared in the mid secretory endometrium.2.COH made the pinopode appeared 2 days ahead of that in natural cycle.Thus individual differences in the opening time of endometrial implantation window increased and the synchronization of the endometrium and embryo changed.3.The ratio of E2/P in peripheral blood of COH cycle was significantly higher than that in natural cycle group,which may because COH decreased the endometrial surface carbohydrate conjugates thickness and caused embryo implantation dysfunction.4.COH significantly influenced the level of hormones.The level of progesterone was too high,so that ER,PR expressed abnormally and the development of the pinopode was affected.5.Early emergence of the pinopodes was related to the high concentration of P,resulting in the advanced appearance of implantation window.Then embryonic developme-nt did not synchronize with pinopode growth,affecting embryo implantation.While the level of E2 had no direct relationship of the development of pinopode.