Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA.
Department of Obstetrics & Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra, South Shore University Hospital, Northwell Health, NY, USA.
Hum Fertil (Camb). 2022 Oct;25(4):662-669. doi: 10.1080/14647273.2021.1871783. Epub 2021 Jan 19.
In patients with high serum E embryo transfer is often postponed, as high E levels adversely affect embryo transfer outcome. We aimed to determine if stratified serum oestradiol (E) and progesterone (P) levels differentially affect endometrial histology and endometrial oestrogen and progesterone receptor protein levels. Endometrial biopsies were collected from oocyte donors. Samples were divided based on peak serum E levels into three groups: (i) low-E ( = 33) E≤2999pg/mL; (ii) mid-E ( = 40) E 3000-4999 pg/mL; and (iii) high-E ( = 15) E≥5000 pg/mL. Oestrogen receptor alpha (ERα) and progesterone receptors A and B (PR) protein levels in endometrial stroma (S), glandular (GE) and luminal (LE) epithelia were assessed by immunohistochemistry. Samples in high-E group demonstrated strongest association with accelerated endometrial maturation (2 (1-2); 2 (1-3); and 3 (2.8-3) median days of advancement of endometrial maturation respectively in low, mid, high-E groups, = 0.046). There were significant differences in ERα and PR immunoexpression in S, GE and LE among the groups ( < 0.05). Higher E levels were associated with decreased ERα expression ( < 0.017) in GE and LE, and increased PR expression in S and GE ( < 0.011 and < 0.0001, respectively). Higher serum E levels were associated with impaired endometrial steroid hormone receptor expression, higher serum P and more advancement of endometrial maturation.
在血清 E 水平较高的患者中，通常会推迟胚胎移植，因为高 E 水平会对胚胎移植结局产生不利影响。我们旨在确定分层的血清雌二醇（E）和孕酮（P）水平是否会对子宫内膜组织学和子宫内膜雌激素和孕激素受体蛋白水平产生不同影响。从卵母细胞供体中采集子宫内膜活检。根据峰值血清 E 水平将样本分为三组：（i）低 E（=33）E≤2999pg/ml；（ii）中 E（=40）E 3000-4999pg/ml；和（iii）高 E（=15）E≥5000pg/ml。通过免疫组织化学评估子宫内膜基质（S）、腺体（GE）和腔上皮（LE）中雌激素受体 alpha（ERα）和孕激素受体 A 和 B（PR）蛋白水平。高 E 组的样本与加速子宫内膜成熟的相关性最强（低、中、高 E 组分别为 2（1-2）、2（1-3）和 3（2.8-3）中位天，=0.046）。在 S、GE 和 LE 中，各组之间的 ERα 和 PR 免疫表达存在显著差异（<0.05）。E 水平较高与 GE 和 LE 中 ERα表达减少（<0.017）以及 S 和 GE 中 PR 表达增加（<0.011 和<0.0001）相关。较高的血清 E 水平与子宫内膜甾体激素受体表达受损、较高的血清 P 水平和子宫内膜成熟度的提高有关。
