Early Pregnancy and Gynaecology Assessment Unit, King's College Hospital, London, UK.
Reprod Biomed Online. 2009 Nov;19(5):737-44. doi: 10.1016/j.rbmo.2009.06.011.
Endometrial polyps have been associated with infertility and early pregnancy loss. The aim of this study was to investigate the effect of hysteroscopic polypectomy on the concentrations of endometrial implantation factors in uterine flushings. Pre-menopausal women with a certain diagnosis of endometrial polyp on contrast-enhanced transvaginal ultrasound scan were recruited into this prospective study. In all women, paired samples of uterine flushings were obtained on the same day of the menstrual cycle prior to and post hysteroscopic polypectomy. Enzyme-linked immunoassays were performed to analyse glycodelin, interleukin-6 (IL-6), interleukin-10 (IL-10), tumour necrosis factor alpha (TNFalpha) and osteopontin, whilst immunoradiometric assay was used to analyse insulin-like growth factor binding protein-1 (IGFBP-1). Concentrations of IGFBP-1, TNFalpha and osteopontin in uterine flushings were significantly lower in the mid-secretory phase prior to polypectomy in comparison to the measurements obtained after complete surgical removal of the polyp (P < 0.05). There were no differences in the concentrations of glycodelin, IL-6 and IL-10 in paired samples prior to and post-polypectomy. The presence of endometrial polyps is associated with decreased mid-secretory concentrations of IGFBP-1, TNFalpha and osteopontin, which are reversed following surgical polypectomy.
子宫内膜息肉与不孕和早期妊娠丢失有关。本研究旨在探讨宫腔镜息肉切除术对子宫内膜种植因子在子宫冲洗液中浓度的影响。经阴道超声增强扫描诊断为子宫内膜息肉的绝经前妇女被纳入本前瞻性研究。所有妇女均在宫腔镜息肉切除术前和术后同一天的月经周期同一天采集配对的子宫冲洗液样本。采用酶联免疫吸附试验分析糖蛋白 11、白细胞介素 6（IL-6）、白细胞介素 10（IL-10）、肿瘤坏死因子 α（TNFalpha）和骨桥蛋白，免疫放射分析用于分析胰岛素样生长因子结合蛋白 1（IGFBP-1）。与完全切除息肉后获得的测量值相比，息肉切除术前的分泌中期子宫冲洗液中 IGFBP-1、TNFalpha 和骨桥蛋白的浓度显着降低（P <0.05）。术前和术后配对样本中糖蛋白 11、IL-6 和 IL-10 的浓度没有差异。子宫内膜息肉的存在与 IGFBP-1、TNFalpha 和骨桥蛋白的分泌中期浓度降低有关，这些浓度在手术后切除息肉后得到逆转。
