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目的分析不同病因不孕人群自然周期子宫内膜血管内皮生长因子(vascular endothelial growth factor receptor,VEGF)表达的差异,探讨VEGF对同周期体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVFET)妊娠结局的影响。方法 2014年1月至2014年12月在首都医科大学附属北京妇产医院生殖中心接受IVF-ET助孕的不孕患者67例,其中原因不明不孕28例,男性因素不孕39例。所有患者监测自然周期排卵,于排卵后5-7天抽取子宫内膜分泌物,同周期采用黄体中期长方案行控制性超促排卵,在阴道B超引导下行取卵术,受精后常规培养72h后进行胚胎移植。胚胎移植后35天B超检测宫腔内可见妊娠囊者为临床妊娠。使用Luminex法检测子宫内膜分泌物中VEGF的表达水平。采用SPSS18.0软件进行统计分析。结果不明原因不孕症患者子宫内膜分泌的血管内皮生长因子VEGF明显低于男性因素不孕患者(P=0.002);妊娠组患者子宫内膜分泌的VEGF明显高于非妊娠组(P=0.006)。结论子宫内膜分泌中期VEGF的表达与IVF-ET妊娠结局呈正相关;子宫内膜局部VEGF分泌不足可能是导致不明原因不孕患者妊娠失败的原因之一。
Objective To analyze the difference of expression of vascular endothelial growth factor receptor (VEGF) in natural period endometriosis in different etiological infertility population and to investigate the effect of VEGF on in vitro fertilization-embryo transfer (IVFET) pregnancy The impact of the outcome. Methods From January 2014 to December 2014, 67 infertile women receiving IVF-ET were enrolled in the Reproductive Center of Beijing Maternity Hospital Affiliated to Capital Medical University from January 2014 to December 2014. Among them, 28 were infertile with unknown causes and 39 were infertile men. All patients were monitored for natural cycle ovulation, uterine endometrial secretions were taken 5-7 days after ovulation, controlled ovulation was performed with mid-term luteal phase for the same period, ovulation was performed by vaginal ultrasound B, and routinely cultured for 72 hours after fertilization After the embryo transfer. 35 days after embryo transfer B-detection of intrauterine gestational sac were clinical pregnancy. Luminex assay was used to detect the expression of VEGF in endometrial secretions. Using SPSS18.0 software for statistical analysis. Results unexplained endometrial infertility in patients with endometrial secretion of vascular endothelial growth factor VEGF was significantly lower than male infertility patients (P = 0.002); pregnancy group of endometrial secretions of VEGF was significantly higher than non-pregnant group (P = 0.006 ). Conclusion The expression of VEGF in the middle stage of endometrial secretion is positively correlated with the pregnancy outcome of IVF-ET. Insufficient secretion of VEGF in the endometrium may be one of the causes of pregnancy failure in patients with unexplained infertility.