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不孕症患者在着床方面的缺陷 ,尤其是内膜接受性的异常可能是导致发病的一个关键因素。近年来文献报道 ,正常人类着床期子宫内膜细胞外基质Ⅳ型胶原、层粘连蛋白 (LN)的表达呈周期特征性 ,可作为内膜接受性标志。Ⅳ型CL、LN的变化 ,可作为能否顺利进行着床的条件之一 ,并受卵巢激素和某些生长因子、细胞因子调节 ,参与着床过程。胚胎的着床受滋养层介导 ,在着床过程中 ,Ⅳ型CL、LN的高表达可阻止胚泡植入而致不孕。目的 :探讨女性不孕症在着床方面的缺陷 ,尤其是子宫内膜接受性的异常。方法 :采用免疫组织化学方法对生育组 4 1例 ,原因不明不孕组 4 3例妇女细胞外基质Ⅳ型CL、LN在分泌期子宫内膜中的表达进行检测。结果 :Ⅳ型CL、LN在生育组分泌中期呈强表达 ,早期次之 ,晚期较弱。不孕组分泌各期表达均高于生育组 ,并且Ⅳ型CL、LN在分泌期子宫内膜上的表达在生育组与不孕组间不同 ,在同一组子宫内膜腺上皮细胞及基底膜 ,血管内皮细胞及基底膜和间质细胞上表达不同。结论 :Ⅳ型CL、LN在分泌期子宫内膜上呈周期特征性变化并参与子宫内膜的功能变化及胚泡的着床环节。其过高表达影响胚泡对母体子宫内膜的识别、定位和粘着过程 ,导致胚泡着床失败
Infertility in implantation of patients with defects, especially the endometrial receptivity may be one of the key factors leading to the disease. In recent years, it has been reported in the literature that the expression of type Ⅳ collagen and laminin (LN) in endometrial extracellular matrix of normal human implantation stage is periodic and can be used as a mark of endometrial receptivity. Type Ⅳ CL, LN changes, as one of the conditions for the successful implantation, and by ovarian hormones and certain growth factors, cytokines, involved in implantation process. Embryo implantation is mediated by trophoblast. During implantation, the high expression of type IV CL and LN can prevent the implantation of blastocyst and cause infertility. OBJECTIVE: To investigate the implantation defects of female infertility, especially the abnormal endometrial receptivity. Methods: Immunohistochemical method was used to detect the expression of extracellular matrix type Ⅳ, LN in secretory endometrium in 43 cases of fertility group and 43 cases of unexplained infertility group. Results: Type Ⅳ CL and LN were strongly expressed in the middle part of fertility group, followed by the latter and later. The expressions of infertility components at all stages were higher than that of the reproductive groups, and the expressions of type Ⅳ CL and LN in the secretory phase of endometrium were different between the fertility group and infertility group. In the same group of endometrial glandular epithelial cells and basement membrane , Vascular endothelial cells and basal membrane and interstitial cells on the expression of different. CONCLUSION: Type IV CL and LN have periodic characteristic changes in secretory endometrium and participate in functional changes of endometrium and implantation of blastocyst. Its overexpression affects the recognition, localization and adhesion of the blastocyst to the maternal endometrium, resulting in the failure of blastocyst implantation