Ma Wen-ge, Song Haengseok, Das Sanjoy K, Paria Bibhash C, Dey Sudhansu K
Division of Reproductive and Developmental Biology and Department of Pediatric, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
Proc Natl Acad Sci U S A. 2003 Mar 4;100(5):2963-8. doi: 10.1073/pnas.0530162100. Epub 2003 Feb 24.
Many underlying causes of human infertility have been overcome by using in vitro fertilization (IVF) and embryo transfer (ET) techniques. Nevertheless, implantation rates in IVF programs remain low despite the transfer of apparently healthy embryos. This suggests that there are problems with the differentiation of the uterus to the receptive state in response to the ovarian hormones estrogen and progesterone. The molecular basis of this receptive state when the uterine environment is conducive to blastocyst acceptance and implantation remains poorly understood. Normally, the "window" of uterine receptivity lasts for a limited time. Using ETs and the progesterone-treated delayed-implantation model in mice, we demonstrate here that levels of estrogen within a very narrow range determine the duration of the window of uterine receptivity. Although estrogen at different physiological concentrations can initiate implantation, we find that the window of uterine receptivity remains open for an extended period at lower estrogen levels but rapidly closes at higher levels. The uterine refractoriness that follows the receptive state at high estrogen levels is accompanied by aberrant uterine expression of implantation-related genes. These results suggest that careful regulation of estrogen levels is one of the important factors for improvement of female fertility in IVFET programs.
通过使用体外受精(IVF)和胚胎移植(ET)技术,人类不孕不育的许多潜在原因已被克服。然而,尽管移植的胚胎看似健康,但IVF程序中的着床率仍然很低。这表明,子宫在对卵巢激素雌激素和孕酮作出反应时,向接受状态的分化存在问题。当子宫环境有利于囊胚接受和着床时,这种接受状态的分子基础仍知之甚少。正常情况下,子宫接受性的“窗口期”持续时间有限。在这里,我们利用ET和孕酮处理的小鼠延迟着床模型,证明了非常窄范围内的雌激素水平决定了子宫接受性窗口的持续时间。尽管不同生理浓度的雌激素都能启动着床,但我们发现,在较低雌激素水平下,子宫接受性窗口会延长开放,而在较高水平下则会迅速关闭。高雌激素水平下接受状态后的子宫不应性伴随着着床相关基因在子宫中的异常表达。这些结果表明,仔细调节雌激素水平是提高IVFET程序中女性生育能力的重要因素之一。