(,, ) , ; : αvβ3, -9(MMP-9) A P450 IgG IgA ; : HOXA10 HOXA11, MMP-2 MMP-9 ; 17β- (17β- HSDs), EMs : R : A : X(2014)

Transcription

1 34 7 Vol.34 No Jul Reproduction & Contraception doi /j.issn X randc_journal@163.com ( ) () αvβ3-9(mmp-9) A P450 IgG IgA HOXA10 HOXA11 MMP-2 MMP-9 17β- (17β- HSDs) () R A X(2014) ) (endometriosis ) ( ART 1.1 [2] [3] 1 [1] 30%~50% 25%~50% (assisted reproductive technology ART) - (in vitro fertilization-embryo transfer IVF-ET) Tel quansong@smu.edu.cn 590 [5] [6] [4] (VEGF) T (RANTES) A(PAPP-A) (interleukin IL)-6 IL-10 (tumor necrosis factor TNF)-α

2 (ROS) DNA E2(PGE2) (PRL) β- (β-ep) Hugh [13] HOXA10 HOXA10 [14] 1.2 ART ART [78] ART IVF-ET [15] 2 77% 20~24 7~9 d [9] HOXA [10] 3 ( α vβ 3 α 1β 1 α 4β 1) [16] α vβ 3 24~48 h [11] α vβ 3 [17] α vβ 3 [12] αvβ3 αvβ3-9(mmp-9) A P450 [1218] HOXA10 αvβ3 591

3 DNA [19] αvβ IL-11 (leukemia inhibitory factor LIF) IL-6 JAK/ STAT LIF IL-11 Dimitriadis IL-11 LIF [20] LIF IL-11 IL-11 LIF Alizadeh [21] LIF Mikolajczyk [22] IgG IgA IL-1 IL-2 TNF (epidermal growth factor EGF) IL-1 [23] (Hb-EGF) Trophinin-tastin-bystin Trophinintastin-bystin Trophin 2.3 HOX [24] HOXA10 HOXA11 HOXA10 HOXA11 [25-27] HOXA10 HOXA11 DNA DNA 3A HOX DNA DNA HOX HOX Jana [28] HOXA10 HOXA11 MMP-2 MMP-9 HOXA10 HOXA11 HOX 2.4 ( ) (progesterone receptor PR)A B [29] 17β- (17β-hydroxysteroid dehydrogenase 17β-HSDs)I Acién [30] (PR)-A PR-B 17β- HSD-2 (E2)

4 (gonadotropin releasing hormone agonist GnRHa) Meta [31] GnRHa IVF-ET ESHER [32] GnRHa (A ) GnRHa + [33] [34] GnRHa LIF αvβ3 HOXA10 IVF-ET + + (FET) [33] IL-11 LIF HOX [1] Practice Committee of the American Society for Reproductive Medicine. Endometriosis and infertility a committee opinion. Fertil Steril (3) [2] Olive DL Lindheim SR Pritts EA. Endometriosis and infertility what do we do for each stage? Curr Women Health Reprod (5) [3] Bulleti C Ziegler D. Uterine contractility and embryo implantation. Curr Opin Obstet Gynecol (4) [4] Somigliana E Infantino M Benedetti F et al. The presence of ovarian endometriomas is associated with a reduced responsiveness to gonadotrophins. Fertil Steril (1) [5] De Hondt A Peeraer K Meuleman C et al. Endometriosis and subfertility treatment a review. Minerva Ginecol (3) [6] Neukomm C Mueller MD. New insights into the pathophysiology of endometriosis. Gynakol Geburtshilfliche Rundsch (3) [7] (7)521. [8] Harb HM Gallos ID Chu J et al. The effect of endometriosis on in vitro fertilisation outcome a systematic review and meta-analysis. BJOG (11) [9] (2) [10] Adams SM Gayer N Terry V et al. Manipulation of the follicular phase Uterodomes and pregnancy - is there a correlation? BMC Pregnancy Childbirth (1)2. [11] Nardo LG Nikas G Makrigiannakis A et al. Synchronous expression of pinopodes and alpha v beta 3 and alpha 4 beta 1 integrins in the endometrial surface epithelium of normally menstruating women during the implantation window. J Reprod Med (5) [12] Cakmak H Taylor HS. Molecular mechanisms of treatment resistance in endometriosis the role of progesterone-hox gene interactions. Semin Reprod Med (1) [13] Bagot CN Kliman HJ Taylor HS. Maternal Hoxa10 is required for pinopod formation in the development of mouse uterine receptivity to embryo implantation. Dev Dyn (3) [14] Ordi J Creus M Casamitjana R et al. Endometrial pinopode and alphavbeta3 integrin expression is not impaired in infertile patients with endometriosis. J Assist Reprod Genet (11) [15] Fedele L Marchini M Bianchi S et al. Structural and ultrastructural defects in preovulatory endometrium of normo-ovulating infertile women with minimal or mild endometriosis. Fertil Steril (6) [16] Illera MJ Juan L Stewart CL et al. Effect of peritoneal fluid from women with endometriosis on implantation in the mouse model. Fertil Steril (1)41-8. [17] Lessey BA Castelbaum AJ Sawin SW et al. Aberrant integrin expression in the endometrium of women with endometriosis. J Clin Endocrinol Metab (2) [18] Jana SK Banerjee P Mukherjee R et al. HOXA-11 mediated dysregulation of matrix remodeling during implantation window in women with endometriosis. J Assist Reprod Genet (11) [19] Casals G Ordi J Creus M et al. Expression pattern of osteopontin and αυβ3 integrin during the implantation window in infertile patients with early stages of endometriosis. Hum Reprod (3) [20] Dimitriadis E Stoikos C Stafford-Bell M et al. Interleukin- 11 IL-11 receptoralpha and leukemia inhibitory factor are dysregulated in endometrium of infertile women. J Reprod Immunol (1)

5 [21] Alizadeh Z Shokrzadeh N Saidijam M et al. Semi-quantitative analysis of HOXA11 leukemia inhibitory factor and basic transcriptional element binding protein 1 mrna expression in the mid-secretory. Iran Biomed J (3) [22] Mikolajczyk M Wirstlein P. Leukaemia inhibitory factor and interleukin 11 levels in uterine flushings of infertile patients with endometriosis. Hum Reprod (12) [23] Malhotra N Karmakar D Tripathi V et al. Correlation of angiogenic cytokines-leptin and IL-8 in stage type and presentation ofendometriosis. Gynecol Endocrinol (3) [24]. Trophin (6) [25]. HOXA (11) [26] Gui Y Zhang J Yuan L et al. Regulation of HOXA-10 and its expression in normal and abnormal endometrium. Mol Hum Reprod (9) [27] Matsuzaki S Canis M Darcha C et al. HOXA-10 expression in the mid-secretory endometrium of infertile patients with either endometriosis uterine fibromas or unexplained infertility. Hum Reprod (12) [28] Jana SK Banerjee P Mukherjee R et al. HOXA-11 mediated dysregulation of matrix remodeling during implantation window in women with endometriosis. J Assist Reprod Genet (11) [29] Kayisli UA Korgun ET Akkoyunlu G. Expression of integrin alpha5 and integrin beta4 and their extracellular ligands fibronectin and laminin in human decidua during early pregnancy and its sex steroid mediated regulation. Acta Histochem (3) [30] Acién P Velasco I. Endometriosis a disease that remains enigmatic. ISRN Obstet Gynecol doi /2013/ [31] Sallam HN Garcia-Velasco JA et al. Long-term pituitary down-regulation before in vitro fertilization (IVF) for women with endometriosis. Cochrane Database Syst Rev (1)CD [32] Gelbaya TA Gordts S D Hooghe TM et al. Management of endometrioma prior to IVF compliance with ESHRE guidelines. Reprod Biomed Online (3) [33] (7) [34]. GnRHa (3) ( ) Characteristic of Endometrial Receptivity and Implantation Window in Women with Endometriosis Ya-li SONG Song QUAN (Center of Reproductive Medicine Department of Obstetrics and Gynecology Nanfang Hospital Southern Medical University Guangzhou ) ABSTRACT Endometriosis () can affect females ability of fertility and therapeutic effect of infertility through various processes. There are many aspects to exam the differences of endometrium among patients with both and infertility. Firstly cytologic aspect expression quantity of pinopodes quantity of endometrial glands quantity of mitotic cells in stromata of whom are significantly fewer compared with healthy controls. Moerover the distribution of glandular lumens is irregular the number of microvilli is few and cilia is incomplete regeneration and dysplasia. Secondly from molecular biologic aspect endometrial integrin αvβ3 within planting window period decrease with abnormality of multiple cytokines such as matrix metalloproteinase-9 (MMP-9) extracellular matrix activin-a cell adhesion molecules aromatase P450 IgG IgA ect. Thirdly from genetics the low level expression of HOXA10 and HOXA11 higher expression of MMP-2 and MMP-9 and non-expression of steroid hormones17βhydroxy steroid dehydrogenase (17β-HSDs) lower the patients endometrium receptivity. In addition the pretreatment of gonadotropin releasing hormone agonist can improve the endometrium receptivity of women with effectively. Key words endometriosis () endometrium receptivity implantation window 594