子宫输卵管造影对子宫内膜HOXA - 10和HOXA - 11 mRNA表达的影响：一项临床试验。
Impact of hysterosalpingography on endometrial HOXA-10 and HOXA-11 mRNA expression: A clinical trial.
作者信息
Ozdemir Fatma, Demir Mustafa Bertan, Kutuk Serhan, Karaman Enes, Muderris Iptisam Ipek, Celik Onder, Dalkilic Semih, Dalkilic Lutfiye Kadioglu
机构信息
Department of Obstetrics and Gynecology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
Department of Obstetrics and Gynecology, Kayseri City Hospital, Kayseri, Turkey.
出版信息
Medicine (Baltimore). 2025 May 9;104(19):e42393. doi: 10.1097/MD.0000000000042393.
BACKGROUND
Homeobox genes (HOX) are the basic molecules that regulate endometrial receptivity, decidualization, and progesterone response. This study was designed to investigate the effects of the classical hysterosalpingography (HSG) procedure on endometrial HOXA-10 and 11 mRNA expression.
METHODS
Thirty-five primary infertile patients who applied for investigation of infertility etiology and were approved for conventional HSG were included in the study. Ten fertile patients who required biopsy due to an endometrial pathology were accepted as a control group. Women in HSG group were eligible to participate in the study if they were between 22 and 34 years of age, had spontaneous menstrual cycles, and had been trying to conceive for at least 1.5 year and if there was an indication for evaluation of tubal patency with hysterosalpingography. First endometrial sampling was performed with a pipelle before the contrast-medium infusion during the HSG. Endometrial sampling was collected for the second time with a pipelle cannula in the midluteal phase of the next cycle in all cases undergoing HSG. HOXA-10 and 11 mRNA expressions in the endometrial tissues obtained before HSG and respective endometrial tissues after HSG were measured with RT-PCR.
RESULTS
Pre-HSG average ΔCt values of HOXA-10 and HOXA-11 mRNA were found to be significantly lower than fertile controls (4.30 vs 6.74, P < .001; 3.93 vs 6.74, P < .002). Post-HSG HOXA-10 mRNA levels increased significantly compared to pre-HSG levels (5.66 vs 4.30, P < .01). Post-HSG HOXA-10 mRNA levels increased approximately 4.2-fold compared to pre-HSG levels. Post-HSG HOXA-11 mRNA levels increased significantly compared to pre-HSG levels (4.94 vs 3.93, P < .03). Post-HSG HOXA-11 mRNA levels increased approximately 3.5-fold compared to pre-HSG levels. When the pre-HSG and post-HSG HOXA-10 and HOXA-11 mRNA levels were compared among themselves, the increase in HOXA-10 average ΔCt was significantly higher than the increase in HOXA-11 average ΔCt (5.66 vs 4.94, P < .02.). Similarly, the fold increase in post-HSG mRNA levels was significantly higher in the HOXA-10 group (4.2-fold) than the HOXA-11 group (3.5-fold) (P < .001).
CONCLUSIONS
Conventional HSG procedure improves fertility by increasing endometrial HOXA-10 and HOXA-11 mRNA levels.
背景
同源框基因（HOX）是调节子宫内膜容受性、蜕膜化和孕酮反应的基本分子。本研究旨在探讨传统子宫输卵管造影术（HSG）对子宫内膜HOXA - 10和11 mRNA表达的影响。
方法
本研究纳入了35例申请不孕症病因调查并被批准进行传统HSG的原发性不孕患者。将10例因子宫内膜病变需要活检的 fertile患者作为对照组。HSG组的女性如果年龄在22至34岁之间，月经周期正常，尝试受孕至少1.5年，且有子宫输卵管造影评估输卵管通畅性的指征，则有资格参与研究。在HSG期间注入造影剂之前，先用吸管进行首次子宫内膜采样。在所有接受HSG的病例中，在下一个周期的黄体中期用吸管套管再次采集子宫内膜样本。用逆转录聚合酶链反应（RT-PCR）测量HSG前和HSG后获得的子宫内膜组织中HOXA - 10和11 mRNA的表达。
结果
发现HSG前HOXA - 10和HOXA - 11 mRNA的平均ΔCt值显著低于fertile对照组（4.30对6.74，P <.001；3.93对6.74，P <.002）。与HSG前水平相比，HSG后HOXA - 10 mRNA水平显著升高（5.66对4.30，P <.01）。与HSG前水平相比，HSG后HOXA - 10 mRNA水平增加了约4.2倍。与HSG前水平相比，HSG后HOXA - 11 mRNA水平显著升高（4.94对3.93，P <.03）。与HSG前水平相比，HSG后HOXA - 11 mRNA水平增加了约3.5倍。当比较HSG前和HSG后HOXA - 10和HOXA - 11 mRNA水平时，HOXA - 10平均ΔCt的增加显著高于HOXA - 11平均ΔCt的增加（5.66对4.94，P <.02）。同样，HSG后HOXA - 10组mRNA水平的增加倍数（4.2倍）显著高于HOXA - 11组（3.5倍）（P <.001）。
结论
传统HSG程序通过增加子宫内膜HOXA - 10和HOXA - 11 mRNA水平来提高生育能力。
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