Beier H M, Beier-Hellwig K, Sterzik K
Institut für Anatomie und Reproduktionsbiologie, Medizinische Fakultät, Universitätsklinikum, RWTH Aachen.
Zentralbl Gynakol. 2001 Jun;123(6):319-27. doi: 10.1055/s-2001-16282.
The biological aim of the differentiation and maturation of endometrial tissue compartments during any menstrual cycle is the achievement of suitable conditions for blastocyst implantation and the establishment of pregnancy. Infertility and early embryonic loss are frequently caused by insufficient endometrial differentiation. Even any incomplete receptivity stage of the luteal phase endometrium will prevent attachment and implantation. We have studied the physiological changes throughout an endometrial cycle to elucidate causes of endometrial insufficiency leading to subfertility or infertility. Up to now, the histological changes described by Noyes et al. are understood as classical diagnostic approaches. However, evidence is accumulating that molecular deficits of endometrial differentiation are by no means detectable histologically, and consequently ask for the research on new diagnostic methods and parameters. There are histochemical localizations of specific protein molecules, adhesion molecules and cytokines, which permit by far more detailed and significant molecular analyses than any classical morphological means could yield. Moreover, there are convincing arguments to use further biochemical assessments on proteins of the uterine secretions as specific diagnostic parameters. The electrophoretical resolution presents typical protein patterns, which in turn can be interpreted as characteristic reflexions of the functional phases of the endometrial cycle. What is demonstrated as the so-called adequate luteal phase protein pattern clearly is the product of the receptive endometrium, reflecting the "implantation window". This is established already two days after ovulation and persists usually eight further days, if the endometrial cycle is undisturbed (15th to 24th day of the cycle).
在任何月经周期中，子宫内膜组织各部分分化和成熟的生物学目的是为胚泡着床和妊娠建立创造适宜条件。不孕和早期胚胎丢失常常是由子宫内膜分化不足引起的。即使黄体期子宫内膜的任何不完全接受阶段也会阻止附着和着床。我们研究了整个子宫内膜周期的生理变化，以阐明导致生育力低下或不孕的子宫内膜功能不全的原因。到目前为止，诺伊斯等人描述的组织学变化被认为是经典的诊断方法。然而，越来越多的证据表明，子宫内膜分化的分子缺陷在组织学上根本无法检测到，因此需要研究新的诊断方法和参数。存在特定蛋白质分子、黏附分子和细胞因子的组织化学定位，与任何经典形态学方法相比，这能进行更详细、更有意义的分子分析。此外，有令人信服的理由将对子宫分泌物蛋白质的进一步生化评估用作特定的诊断参数。电泳分辨率呈现出典型的蛋白质图谱，这些图谱又可被解释为子宫内膜周期功能阶段的特征性反映。所谓的黄体期蛋白质图谱被证明显然是接受性子宫内膜的产物，反映了“着床窗”。如果子宫内膜周期未受干扰（月经周期的第15至24天），这在排卵后两天就已确立，通常会持续另外八天。
