子宫内膜植入期胞饮突测量的预后价值
发布时间：2018-12-11 22:48
【摘要】：目的:随着人们生活水平的提高和国家社会的进步,许多从前少见的疾病如高血压、糖尿病发病率逐年升高,而生活环境的改变也导致了不孕不育患者的增多。虽然辅助生殖技术的出现满足了部分患者的生育需求,但妊娠成功率仍然达不到理想的水平。在体外受精-冻融胚胎移植过程中,成功的因素除了优秀的胚胎质量,也取决于子宫内膜容受性。目前已知胞饮突细胞于胚胎植入窗口期在内膜上表达,胞饮突被推测为一种子宫内膜容受性的标志物。我们实验组通过检测植入窗口期胞饮突表达的情况以及分析胚胎移植后的妊娠结局,探索胞饮突是否可以作为子宫内膜容受性的标志,对胚胎移植后成功妊娠是否具有预后价值。方法:选择在我院即将进行FET-HRT周期的172名不孕妇女。其中46名妇女参与了第一部分研究,以在激素替代周期中给予孕酮补充后3至7天(以P+3、P+4天等表示)观察胞饮突的每日变化。其余126例参与了另一部分研究以检查胞饮突计数和激素替代周期冷冻胚胎移植的妊娠率的相关性。此研究使用扫描电子显微镜捕获胞饮突图像,然后使用图像处理程序量化胞饮突计数和形态亚型,摸索胞饮突评估所需的最少视野数,使用改进的胞饮突评分方法进行量化分析。结果:(1)分析显示1个病例需要至少60个内膜面视野来产生可重复的胞饮突评估结果。(2)总胞饮突数在P+6天达到峰值,然后略有下降。完全发育的胞饮突的每视野平均数目也在P+6天达到最大值。(3)胞饮突的表达情况在妊娠成功和妊娠失败的受试者之间显著不同。结论:我们提出的改进的胞饮突复合评分系统对于子宫内膜胞饮突的数量及形态的评估和对子宫内膜容受性的判断具有较大帮助,子宫内膜胞饮突评估对胚胎移植后成功妊娠具有较高预后价值。
[Abstract]:Objective: with the improvement of people's living standard and the progress of national society, many diseases such as hypertension and diabetes are increasing year by year, and the change of living environment leads to the increase of infertile patients. Although the emergence of assisted reproductive technology to meet the reproductive needs of some patients, but the success rate of pregnancy is still not up to the ideal level. In vitro fertilization-freeze-thawing embryo transfer process, success factors, in addition to excellent embryo quality, but also depends on endometrial receptivity. At present, it is known that the proteasome cells express on the endometrium during the implantation window, and the process is supposed to be a biomarker of endometrial receptivity. In our experimental group, we examined the expression of cellular processes during window implantation and analyzed the outcome of pregnancy after embryo transfer to explore whether the process could be used as a sign of endometrial receptivity. It has prognostic value for successful pregnancy after embryo transfer. Methods: 172 infertile women undergoing FET-HRT cycle in our hospital were selected. Forty-six women participated in the first part of the study to observe the daily changes of cellular processes after progesterone supplementation was given 3 to 7 days later (expressed as P 3 / P 4 days). The remaining 126 cases participated in another part of the study to examine the correlation between the number of cell processes and the pregnancy rate of hormone replacement cycle frozen embryo transfer. In this study, scanning electron microscopy was used to capture the image of the process, and then the image processing program was used to quantify the number of counts and morphologic subtypes of the process, and to explore the minimum number of visual fields needed for the assessment of the process. The quantitative analysis was carried out by using the improved grading method of phlogistic process. Results: (1) Analysis showed that at least 60 endomembranous visual fields were needed in one case to produce repeatable evaluation results. (2) the total number of neuronal processes reached its peak at P6 days and then decreased slightly. The average number of fully developed processes per visual field also reached the maximum on P6 days. (3) the expression of proteasome was significantly different between the subjects who were pregnant successfully and failed during pregnancy. Conclusion: the improved compound grading system is helpful for the evaluation of the number and morphology of the process and the judgment of the receptivity of the endometrium. The evaluation of endometrial cell process has high prognostic value for successful pregnancy after embryo transfer.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.8
，
本文编号：2373364
[Abstract]:Objective: with the improvement of people's living standard and the progress of national society, many diseases such as hypertension and diabetes are increasing year by year, and the change of living environment leads to the increase of infertile patients. Although the emergence of assisted reproductive technology to meet the reproductive needs of some patients, but the success rate of pregnancy is still not up to the ideal level. In vitro fertilization-freeze-thawing embryo transfer process, success factors, in addition to excellent embryo quality, but also depends on endometrial receptivity. At present, it is known that the proteasome cells express on the endometrium during the implantation window, and the process is supposed to be a biomarker of endometrial receptivity. In our experimental group, we examined the expression of cellular processes during window implantation and analyzed the outcome of pregnancy after embryo transfer to explore whether the process could be used as a sign of endometrial receptivity. It has prognostic value for successful pregnancy after embryo transfer. Methods: 172 infertile women undergoing FET-HRT cycle in our hospital were selected. Forty-six women participated in the first part of the study to observe the daily changes of cellular processes after progesterone supplementation was given 3 to 7 days later (expressed as P 3 / P 4 days). The remaining 126 cases participated in another part of the study to examine the correlation between the number of cell processes and the pregnancy rate of hormone replacement cycle frozen embryo transfer. In this study, scanning electron microscopy was used to capture the image of the process, and then the image processing program was used to quantify the number of counts and morphologic subtypes of the process, and to explore the minimum number of visual fields needed for the assessment of the process. The quantitative analysis was carried out by using the improved grading method of phlogistic process. Results: (1) Analysis showed that at least 60 endomembranous visual fields were needed in one case to produce repeatable evaluation results. (2) the total number of neuronal processes reached its peak at P6 days and then decreased slightly. The average number of fully developed processes per visual field also reached the maximum on P6 days. (3) the expression of proteasome was significantly different between the subjects who were pregnant successfully and failed during pregnancy. Conclusion: the improved compound grading system is helpful for the evaluation of the number and morphology of the process and the judgment of the receptivity of the endometrium. The evaluation of endometrial cell process has high prognostic value for successful pregnancy after embryo transfer.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.8
，
本文编号：2373364
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