背景:异位妊娠(EP)定义为子宫组织外胚胎的植入和发育。接受辅助生殖技术(ART)的妇女,特别是冷冻胚胎移植(FET),是EP的高危人群。粘蛋白1(MUC1),成纤维细胞生长因子-2(FGF2),和肝素结合表皮生长因子(HBEGF)基因参与子宫内膜容受性途径,导致正常的原位植入;虽然,它们与FET后输卵管妊娠的相关性尚不清楚.我们旨在评估FET周期后EP患者中Mucin1,FGF2和HBEGF表达倍数作为子宫内膜接受标志物。
方法:对10名患者进行了病例对照研究(假性妊娠组5名EP患者和5名妇女,作为对照样品)。假性妊娠组建立在良性疾病子宫切除术的妇女中。在子宫切除术期间,对这些患者进行了输卵管活检和相应的子宫内膜组织。然而,在输卵管切除术中获得EP患者的输卵管和子宫内膜组织。采用实时聚合酶链反应(PCR)法检测输卵管和子宫内膜组织中Mucin1、FGF2和HBEGF基因的mRNA表达。
结果:病例组子宫内膜MUC1mRNA表达水平高于对照组(P=0.04);与对照组相比,病例组输卵管标本中mRNA的表达显着降低(P=0.001)。病例与对照子宫内膜HBEGFmRNA表达水平无显著差异,与对照组相比,其在输卵管样本中的表达显着增加(P=0.001)。在病例组的输卵管样品中观察到相同的模式的FGF2mRNA表达水平,但与对照样品相比,子宫内膜样品中的FGF2mRNA表达水平显着降低(P=0.03)。
结论:Mucin1,FGF2和HBEGF基因mRNA表达的变化可能解释了子宫胚胎排斥反应和输卵管细胞接受表型的建立。
BACKGROUND: Ectopic pregnancy (EP) is defined as implantation and development of an embryo outside of the uterine tissue. Women undergoing assisted reproductive technologies (ART), particularly frozen embryo transfer (FET), are in high-risk populations for EP. Mucin1 (MUC1), fibroblast growth factor-2 (FGF2), and Heparin-binding epidermal growth factor (HBEGF) genes are involved in the endometrial receptivity pathway, leading to normal eutopic implantation; Although, their relevance in the tubal pregnancy after FET is unknown. We aimed evaluation of Mucin1, FGF2, and HBEGF expression fold as endometrial receptive markers in the EP patients following the FET cycle.
METHODS: A
case-control study was conducted on ten patients (five EP patients and five women in the pseudo-pregnancy group, as the control samples). Pseudo-pregnancy group was established in women who were candidates for hysterectomy for benign diseases. Fallopian tube biopsies and corresponding endometrial tissues from these patients were taken during the hysterectomy. However, the fallopian tube and endometrial tissues of EP patients were obtained during salpingectomy. The mRNA expressions of Mucin1, FGF2, and HBEGF genes in the fallopian tube and endometrial tissues were measured by real-time polymerase chain reaction (PCR) assay.
RESULTS: MUC1 mRNA expression level in the endometrium of the
case group was higher than in the control group (P=0.04); however, its mRNA expression in the fallopian samples of the
case group in comparison with the control group was significantly decreased (P=0.001). The HBEGF mRNA expression level was not significantly different between the case and control endometrium, whereas its expression was significantly increased in the
case fallopian samples compared with the control ones (P=0.001). The same pattern was observed for FGF2 mRNA expression level in the fallopian samples of the
case group but was significantly reduced in the endometrial samples in comparison with the control samples (P=0.03).
CONCLUSIONS: Mucin1, FGF2, and HBEGF gene mRNA expression changes may explain the embryo rejection from the uterus and the establishment of a receptive phenotype in fallopian cells.