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1 34 7 Vol.34 No Jul Reproductio & Cotraceptio doi: /j.iss X radc_joural@163.com () ( ) ( ) : () : - (IVF-ET) 2 1 (=60) IVF-ET 1~6 (=30) : (P<0.05); (P>0.05) (P<0.05) (EMI) () () (P<0.05); (P>0.05) ET 62.5%(35/56) 33.3%(9/27) (P<0.05) : : (); ; - (IVF-ET); ; (); () : R : A : X(2014) : ; Tel: ; ladashegzhi@126.com IVF (graulocyte-coloy stimulatig factor ) [1-4] [5] IVF-ET 527

2 iterface EMI) (edometrial myometrial : <0.7 cm 1 IVF-ET : Goe Capser A B C A : 4 ; B : 3 ; C : ; 0 ; 1/3 4 ; 1/3~2/3 3 ; 2/3 2 ; 1 ; ; 2 ml rhg- CSF( ) 300 μg 2 ml 10 mi 48 h 96 h ; 1~6 0 h 48 h 96 h 3 2~3 14~16 d hcg 30 d ( GE LOGIQ E9 5~9 MHz) 1.4 SPSS19.0 (x s) t Sg-Rak Kruskal-wallis P< (BMI) (P>0.05) h 1 (P>0.05) 96 h 1 (x s) Table 1 Basic lie of patiets Item group Cotrol P ( ) Age (year) (a) Duratio of ifertility BMI (kg/m 2 ) Score of embryo quality Score of edometrium before perfusio

3 (P<0.05) 48 h 96 h 1 (P>0.05); () ()48 h 1 (P<0.05) 48 h 96 h (P<0.05); 48 h 96 h (P<0.05); 48 h (P<0.05) 48 h 96 h (P<0.05) h 96 h (P>0.05); 48 h 1 (P<0.05) 48 h 96 h (P< 0.05); 48 h 96 h (P<0.05); 48 h (P<0.05) 48 h (P<0.05) (P>0.05); 96 h (P<0.05) h 0 h 2 (x s) Table 2 Chages of edometrial thickess EMI s echo ad blood perfusio i the early follicular phase Idex group Cotrol Pre-ifusio (cm) h Perfusio after 48 h (cm) *# *# *# *# 96 h Perfusio after 96 h (cm) *# *# *: P<0.05 ( t ) compared with the cotrol (usig idepedet sample t test) #: P<0.05 ( ) compared with pre-ifusio i the same group (usig repeated ANOVA) # # # (x s) Table 3 Chages of edometrial thickess EMI s echo ad blood perfusio i the late follicular phase Idex group Cotrol Pre-ifusio (cm) h Perfusio after 48 h (cm) # *# *# # 96 h Perfusio after 96 h (cm) *# *# *: P<0.05 ( t ) compared with the cotrol (usig idepedet sample t test) #: P<0.05 ( ) compared with pre-ifusio i the same group (usig repeated ANOVA) # #

4 (P<0.05) 1 (P>0.05) 48 h 96 h (P<0.05) 96 h (P<0.05) 48 h (P<0.05) 48 h 96 h 48 h (P<0.05) 48 h 96 h (P>0.05) (P> 0.05) 48 h 96 h 48 h 1 (P>0.05) %(35/56) 33.3%(9/ 27) (P<0.05) 3 IVF-ET 4 (x s) Table 4 Chages of edometrial thickess EMI s echo ad blood perfusio i ovulatio-aroud phase Idex group Cotrol Pre-ifusio (cm) h Perfusio after 48 h (cm) # * *# *# 96 h Perfusio after 96 h (cm) # *# *: P<0.05 ( t ) compared with the cotrol (usig idepedet sample t test) #: P<0.05 ( ) compared with pre-ifusio i the same group (usig repeated ANOVA) # ~10 mm 2 ml >5 mm 2 <7 mm [6] [7] [8] (M-CSF) - (GM-CSF) : 530

5 [9] (CSF) [1] [1011] [2] [341213] [14] IVF-ET [15] [316] IVF [10] [22] M-CSF PRL 8-Br-cAMP M-CSF PRL CSF [17] Gleicher 4 <7 mm 300 μg/ml Gleicher [4] rh 300 μg ; 48 h CSF (CSF-R) [1819] M-CSF NK [2021] [22] (PRL) 8- (8-BrcAMP) M-CSF [23] [24-26] M-CSF CSF [4] G- CSF [2728] ; 48 h ; ; CSF [1] Yaagi K Makioda S Fujii R et al. Cyclic chages of graulocyte coloy-stimulatig factor () mrna i 531

6 the huma follicle durig the ormal mestrual cycle ad immuolocalizatio of protei. Hum Reprod (2): [2] Narahara H Mie SI Kawao Y et al. Effects of coloystimulatig factors o the secretio of platelet-activatig factor acetylhydrolase by huma decidual macrophages. Fertil Steril (1): [3] Carter D. Compositios ad methods for reducig the likelihood of implatatio failure or miscarriage i recipiets of artificial isemiatio. US patet applicatio 2009/ A1. September [4] Gleicher N Vidali A Barad DH. Successful treatmet of uresposive thi edometrium. Fertil Steril (6): 2123.e13-e17. [5] Clark DA. Is there ay evidece for immuologically mediated or immuologically modifiable early pregacy failure. J Assist Reprod Geet (1): [6] Jarvela IY Sladkevicis P Kelly S et al. Evaluatio of edometrial receptivity durig i vitro fertilizatio usig three-dim esioal power Doppler ultrasoud. Ultrasoud Obstet Gyecol (7): [7].. / (5): [8] Lédé N Chaouat G Serazi V et al. Edometrial vascularity by three-dimesioal power Doppler ultrasoud ad cytokies: a complemetary approach to assess uterie receptivity. J Reprod Immuol (1): [9] Makkoe TA Mi H Jekue A. Graulocyte macrophageoloystimulatig factor (GM-CSF) ad sucralfate i prevetio of radiatio-iduced mueositis: a prospective radomized study. It J Radiat Ocol Biol Phys (3): [10] Salmassi A Schmutzler AG Huag L et al. Detectio of graulocyte coloy-stimulatig factor ad its receptor i huma follicular luteiized graulosa cells. Fertil Steril (Suppl 1): [11] Zhag Z Fag Q Wag J. Ivolvemet of macrophage coloystimulatig factor (M-CSF) i the fuctio of the follicular graulosa cells. Fertil Steril (7): [12] Spadorfer SD Barmat LI Liu HC et al. Graulocyte macrophage-coloy stimulatig factor productio by autologous edometrial co-culture is associated with outcome for i vitro fertilizatio patiets with a history of multiple implatatio failures. Am J Reprod Immuol (5): [13] W urfel W. Approaches to a better implatatio. J Assist Reprod Geet (8):473. [14] Takasaki A Ohba T Okamura Y et al. Cliical use of coloystimulatig factor-1 i ovulatio iductio for poor respoders. Fertil Steril (6): [15] Lédée N Lombroso R Lombardelli L et al. Cytokies ad chemokies i follicular fluids ad potetial of the correspodig embryo: the role of graulocyte coloy-stimulatig factor. Hum Reprod (9): [16] Scarpellii F Sbracia M. Use of graulocyte coloy stimulatig factor for the treatmet of uexplaied recurret miscarriage: a radomized cotrolled trial. Hum Reprod (11): [17] Dieckgraefe BK Korzeik JR. Treatmet of active Croh s disease with recombiat huma graulocyte-macrophage coloy-stimulatig factor. Lacet (9344): [18] Saito S Fukuaga R Ichijo M et al. Expressio of graulocyte coloy-stimulatig factor ad its receptor at the fetomateral iterface i murie ad huma pregacy. Growth Factors (2): [19] McCracke S Layto JE Shorter SC et al. Expressio of graulocyte-coloy stimulatig factor ad its receptor is regulated durig the developmet of the huma placeta. J Edocriol (2): [20] Shorter SC Vice GS Starkey PM. Productio of graulocyte coloy-stimulatig factor at the matero-foetal iterface i huma pregacy. Immuology (3): [21] Saito S Nishikawa K Morii T et al. Cytokie productio by CD16CD56 bright atural killer cells i the huma early pregacy decidua. It Immuol (5): [22] Taaka T Miyama M Masuda M et al. Productio ad physiological fuctio of graulocyte coloy-stimulatig factor () i o-pregat huma edometrial stromal cells. Gyecol Edocriol (6): [23] Pollard JW Bartocci A Arceci R et al. Apparet role of the macrophage growth factor CSF-1 i placetal developmet. Nature (6147): [24] Kariya M Kazaki H Haamura T et al. Progesteroedepedet secretio of macrophage coloy-stimulatig factor by huma edometrial stromal cells of opregat uterus i culture. J Cli Edocriol Metab (1): [25] Hatayama H Kazaki H Iwai M et al. Progesteroe ehaces macrophage coloy-stimulatig factor productio i huma edometrial stromal cells i vitro. Edocriology (5):

7 [26] Kazaki H Hatayama H Narukawa S et al. Hormoal regulatio i the productio of macrophage coloy-stimulatig factor ad trasformig growth factor beta by huma edometrial stromal cells i culture. Horm Res (Suppl 2):30-5. [27] Scholz M Schirm S Wetzler M et al. Pharmacokietic ad dyamic modellig of derivatives i humas. Theor Biol Med Model (9):32. [28] Scholz M Egel C Loeffler M. Modellig huma graulopoiesis uder poly-chemotherapy with support. J Math Biol (4): ( ) Graulocyte Coloy-stimulatig Factor Uterie Perfusio for Iadequate Edometrium Mig-xia GAO 1 Si-tog CHEN 2 Li-fei LI 1 Li-hui ZHAO 1 Xig SHI 1 Xue-lig JIA 1 Xiao-lig MA 1 Xue-hog ZHANG 1 (1. Reproductive Medicie Hospital of the First Hospital of Lazhou Uiversity Lazhou ) (2. Cliical Medicie Colloge of Chogqig Medical Uiversity Chogqig ) ABSTRACT Objective: To study the effect of graulocyte coloy-stimulatig factor () itrauterie perfusio o iadequate edometrium. Methods: 1) Totally 90 wome were collected i a prospective study who had iadequate edometrium thi or exudative chage o edometrial myometrial iterface (EMI) ad repeated implatatio failure. They were radomly divided ito group (=60) ad cotrol group (=30). The patiets i group received itrauterie perfusio with for 1 6 times before IVF-ET while the patiets i the cotrol were ot give. Thickess ad echo of edometrium echo of EMI uder trasvagial ultrasoography haemodyamics ad other idicators were compared. Results: 1) Compared with the cotrol i the early follicular phase ad the late follicular phase edometrial thickess i group icreased sigificatly the EMI s echo was better the differece was statistically sigificat (P<0.05). There was o sigificat differece i edometrial thickess i ovulatio-aroud phase betwee the two groups (P>0.05) but EMI s echo was better tha the cotrol (P<0.05). Artery pulsatio idex () of EMI i group was higher i all these three phases ad resistace idex () i the early follicular phase ad ovulatio aroud phase i group were higher the differece was statistically sigificat (P<0.05). There was o sigificat differece i of the late follicular phase betwee the two groups (P>0.05). The pregacy rate i group ad the cotrol was 62.5% (35/56) ad 33.3% (9/27) respectively the differece was statistically sigificat (P<0.05). Coclusio: itrauterie perfusio ca improve edometrial thickess ad iflammatory exudative chages of EMI. It is effective for patiets with thi edometrium iflammatory exudate chages of EMI ad repeated implatatio failure ad get a better cliical pregacy rate. Key words: graulocyte coloy-stimulatig factor (); edometrial receptivity; i vitro fertilizatio ad embryo trasfer (IVF-ET); three-dimesioal ultrasoud; pulsatility idex (); resistace idex () 533