Prakash Alka, Li Tin C, Tuckerman Elizabeth, Laird Susan, Wells Michael, Ledger William L
Academic Unit of Reproductive and Developmental Medicine, Jessop Wing, United Kingdom.
Fertil Steril. 2006 Dec;86(6):1723-30. doi: 10.1016/j.fertnstert.2006.05.040. Epub 2006 Oct 30.
To compare the luteal phase endometrial expression of inhibin, activin, and follistatin subunits in women with recurrent miscarriage compared to a control group. Other parameters of luteal function assessed included Doppler blood flow, serum biochemical markers, and histopathology.
This was a prospective case control study.
The study was conducted in a tertiary care hospital of Sheffield, United Kingdom.
PATIENT(S): Thirty-three women with recurrent miscarriage and 10 women with no previous history of miscarriage (control group) were recruited.
INTERVENTION(S): Histologic assessment of the luteal phase endometrium was done using Noyes criteria followed by immunohistochemical analysis for expression of inhibin, activin, and follistatin subunits. Doppler analysis for perifollicular and endometrial blood flow was also done. Simultaneously serum concentrations of E(2), LH, FSH, P, and inhibin B at the time of LH surge and at LH +7 days were measured.
Difference in endometrial expression of inhibin, activin, and follistatin subunit in the two groups.
RESULT(S): Endometrial expression of follistatin and beta A in the endometrial stromal cells of women with recurrent miscarriage was significantly lower than in control women. There were no differences in results of the Doppler studies or the hormonal profiles between cases and controls.
CONCLUSION(S): The lower expression of follistatin and beta A subunit in women with recurrent miscarriage may imply an altered activity of activin A at the time of decidualization, which may lead to poor pregnancy outcome in the form of miscarriage.
比较复发性流产女性与对照组黄体期子宫内膜中抑制素、激活素和卵泡抑素亚基的表达。评估的黄体功能其他参数包括多普勒血流、血清生化标志物和组织病理学。
这是一项前瞻性病例对照研究。
该研究在英国谢菲尔德的一家三级护理医院进行。
招募了33名复发性流产女性和10名无流产史女性（对照组）。
使用诺伊斯标准对黄体期子宫内膜进行组织学评估，随后进行免疫组织化学分析以检测抑制素、激活素和卵泡抑素亚基的表达。还进行了卵泡周围和子宫内膜血流的多普勒分析。同时测量促黄体生成素（LH）高峰时及LH +7天时血清中雌二醇（E2）、LH、卵泡刺激素（FSH）、孕酮（P）和抑制素B的浓度。
两组中抑制素、激活素和卵泡抑素亚基的子宫内膜表达差异。
复发性流产女性子宫内膜基质细胞中卵泡抑素和βA的子宫内膜表达明显低于对照女性。病例组和对照组的多普勒研究结果或激素谱无差异。
复发性流产女性中卵泡抑素和βA亚基的低表达可能意味着蜕膜化时激活素A的活性改变，这可能导致以流产形式出现的不良妊娠结局。
