Altınbas University Department of Obstetrics and Gynecology, Istanbul, Turkey.
BAU Medical School Department of Obstetrics and Gynecology, IVF-Center, Istanbul, Turkey.
Reprod Biol Endocrinol. 2022 Jan 10;20(1):11. doi: 10.1186/s12958-021-00877-z.
It is not known by which mechanism endometrial injury increases pregnancy rates. Leukaemia inhibitory factor (LIF) is a cytokine involved in wound healing and implantation. The aim of this study was to determine the change in endometrial LIF mRNA expression before and after mechanical injury during hysteroscopy.
Forty patients with a history of two or more unsuccessful implantations who decided to undergo hysteroscopy in the proliferative phase were divided into two equal groups: one with endometrial injury (scratching group) and the other with noninjury (control group). Endometrial sampling was conducted before injury on the patients in the scratching group, and then injury was performed with monopolar needle forceps. Only diagnostic hysteroscopy was performed on the patients in the control group. Endometrial tissues were collected using a Pipelle catheter between Days 20 and 23 of the mid-luteal phase of the next cycles in both the scratching and control groups. Endometrial LIF mRNA expression was evaluated with the use of reverse-transcription polymerase chain reactions.
Relative changes in mRNA expression levels of the LIF gene in endometrial samples taken before and after injury were calculated using the 2-ΔΔCt method, and the fold changes obtained were compared between and within the groups. Compared with preinjury values, an 11.1-fold increase was found in postinjury LIF mRNA expression in patients with monopolar forceps injury (p < 0.001). There was a 3.9-fold significant increase in postinjury LIF mRNA levels compared with those in the control group (p < 0.02).
The fertility-promoting effect of hysteroscopy-guided mechanical endometrial injury may be mediated by LIF mRNA.
目前尚不清楚子宫内膜损伤是通过何种机制提高妊娠率的。白血病抑制因子（LIF）是一种参与伤口愈合和着床的细胞因子。本研究旨在确定宫腔镜检查过程中子宫内膜损伤前后 LIFmRNA 表达的变化。
40 例有两次或两次以上着床失败史的患者决定在增殖期行宫腔镜检查，将其分为两组，每组 20 例：一组行子宫内膜损伤（搔刮组），另一组不行损伤（对照组）。搔刮组患者在搔刮前进行子宫内膜取样，然后用单极针式电切镜进行损伤。对照组患者仅行诊断性宫腔镜检查。在刮除组和对照组的下一周期的黄体中期第 20 天至第 23 天，使用 Pipelle 导管采集子宫内膜组织。采用逆转录聚合酶链反应评估子宫内膜 LIFmRNA 表达。
采用 2-ΔΔCt 法计算子宫内膜损伤前后 LIF 基因 mRNA 表达水平的相对变化，并比较组间和组内的变化倍数。与损伤前相比，单极电切镜损伤患者的 LIFmRNA 表达增加了 11.1 倍（p<0.001）。与对照组相比，损伤后 LIFmRNA 水平显著增加了 3.9 倍（p<0.02）。
宫腔镜引导下机械性子宫内膜损伤的促生育作用可能通过 LIFmRNA 介导。
