Moberg Christian, Bourlev Vladimir, Ilyasova Natalia, Olovsson Matts
Department of Women's and Children's Health, Uppsala University , Uppsala , Sweden.
Hum Fertil (Camb). 2015 Mar;18(1):30-7. doi: 10.3109/14647273.2014.922705. Epub 2014 Jun 19.
Endometriosis affects fertility in many women and may partly be due to decreased endometrial receptivity. Several mechanisms have been suggested, notably, progesterone resistance for which a number of candidate biomarkers have been suggested. Here we demonstrate aberrant levels of steroid hormone receptors and the small heat shock protein αB-crystallin in eutopic endometrial epithelium from 38 women with peritoneal endometriosis diagnosed during investigation for secondary infertility. Spontaneous pregnancies within 1 year after medical and surgical treatment for endometriosis were recorded and semi-quantitative immunohistochemistry data compared between women with endometriosis who did or did not become pregnant and healthy controls. Stronger immunostaining for ER-α was detected in luminal and glandular endometrial epithelium from women with endometriosis who did not become pregnant during the post-treatment observation period versus endometriosis patients who became pregnant and controls. Staining levels of PR and PR-B were lower in patients without subsequent pregnancies than in the two other groups. Endometrial levels of αB-crystallin in endometriosis patients similar to those in controls were strongly correlated with the chance of becoming pregnant, whereas higher or lower levels were not.
子宫内膜异位症影响许多女性的生育能力，部分原因可能是子宫内膜容受性降低。已经提出了几种机制，特别是孕激素抵抗，对此已经提出了许多候选生物标志物。在此，我们展示了38例在继发性不孕调查期间被诊断为腹膜子宫内膜异位症的女性在位子宫内膜上皮中类固醇激素受体和小热休克蛋白αB-晶状体蛋白水平异常。记录了子宫内膜异位症药物和手术治疗后1年内的自然妊娠情况，并比较了子宫内膜异位症患者中怀孕和未怀孕女性以及健康对照之间的半定量免疫组化数据。与怀孕的子宫内膜异位症患者和对照组相比，在治疗后观察期内未怀孕的子宫内膜异位症女性的子宫内膜腔上皮和腺上皮中检测到更强的雌激素受体α（ER-α）免疫染色。未随后怀孕的患者中孕激素受体（PR）和PR-B的染色水平低于其他两组。子宫内膜异位症患者中与对照组相似的αB-晶状体蛋白水平与怀孕几率密切相关，而较高或较低水平则不然。
