The Study On Endometrial Receptivity Of Infertility With Previous Cesarean Scar Defect

Objective:To investigate the effect of previous cesarean scar defect on the success rate of In vitro fertilization embryo transfer(IVF-ET)and the effect of cervical drainage treatment on infertile patients with previous cesarean scar defect.Methods: 225 cases of previous cesarean scar uterus were selected from 4906 frozen-thawed transfer cycles of the reproductive medicine center of Anhui Medical University from July 1,2016 to June 30,2017.There were 145 cases without PCSD(SU group)and 80 cases with previous cesarean scar defect(PCSD group).Then PCSD group were divided into two subgroups: 32 cases accepted cervical fluid drainage treatment(PCSD-treated group)and 48 cases without drainage treatment(PCSD-untreated group).The clinical data and success rate of ART were analyzed in each group.Results: There were no significant differences between PCSD group and SU group in age,BMI,basal hormone levels.However,the implantation rate(30.30% vs.41.23%,P<0.05)and clinical pregnancy rate(38.27% vs.53.10%,P<0.05)of the PCSD group were significantly lower than the SU group.Although the age and duration of infertility in the PCSD-treated group were higher than those in the PCSD-untreated group,the clinical pregnancy rate of the treatment group was significantly higher than that of the untreatment group(53.13% vs.29.17%,P<0.05).Conclusion: Previous cesarean scar defect could reduce the clinical pregnancy rate of IVF-ET,but the clinical results of patients with treatment for previous cesarean scar defect could be significantly improved by the cervical drainage treatment.Objective:To investigate the expression of integrin beta 3 during the implantation window in infertile patients with previous cesarean scar defect,to explore the impact of cesarean scar defect on endometrial receptivity.Methods: Select 15 patients with previous cesarean scar defect who had prepared to accept the ART treatment during July 2016 to April 2017 at the reproductive medicine center of the First Affiliated Hospital of Anhui Medical University.And 15 infertile patients with tubal factor or male factor were randomly matched as control group excluding endometriosis,polycystic ovary syndrome,ovarian hypofunction,recurrent abortion,and so on which could affected the ART outcome significantly.All patients were monitored ovulation by transvaginal ultrasound,and endometrial tissue was collected through endometrial biopsy on the 6-7 day after ovulation.The endometrial tissue in vitro was divided into 2 part,one part was fixed by 95% alcohol for routine pathological examination,the other part was fixed with 4% paraformaldehyde,paraffin embedded and sectioning,and immunohistochemistry was used to detect the expression of integrin beta 3 in the endometrium.The SPSS 19.0 statistical software was used to carry out statistical analysis of the experimental data.Results: The positive expression of integrin ?3 was found in the endometrium epithelium and glands in the window of implantation,which was located in the cytoplasm and was homogeneous and brown.The expression of integrin ?3 in the endometrium of experimental group was significantly lower than in the control group(OD 0.21 + 0.023 vs.0.18 + 0.02),the difference was statistically significant(P<0.001).The routine pathological results showed that 4 of the endometrium in the experimental group had endometritis,and the control group were all the normal secretory endometrium.Conclusion: Integrin ?3 during the window of implantation of cesarean scar defect was decreased,which suggested that the patients with cesarean scar defect had lower endometrial receptivity.