Ilesanmi A O, Hawkins D A, Lessey B A
Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia 19104.
Microsc Res Tech. 1993 Jun 15;25(3):208-22. doi: 10.1002/jemt.1070250304.
The factors responsible for the initial interaction between maternal and fetal epithelium leading to the establishment of pregnancy remain poorly understood. Temporal and spatial expression of specific endometrial peptides in response to ovarian steroids is thought to contribute to the development of a period of uterine receptivity, whereby the endometrium becomes hospitable to the implanting blastocyst. The failure to establish receptivity may account for a significant percentage of the cases of infertility in the female, especially affecting women with luteal phase deficiency, leiomyomata uteri, endometriosis, habitual abortion, and unexplained infertility. In addition, despite increasing global experience with advanced reproductive technologies, the majority of In Vitro Fertilization (IVF) attempts remain unsuccessful, most likely on the basis of implantation failure. In this article, we review the concepts involved in the study of uterine receptivity in the human, highlight potential immunohistochemical (IHC) markers that have recently been discovered, and discuss how IHC assessment of the endometrium is a potentially valuable method for the evaluation of the receptive endometrial state. Using this approach we have examined several new potential markers of uterine receptivity. Endometrial progesterone receptors and one of the integrin cell adhesion molecules appear to undergo changes in expression around the time of implantation, and may be sensitive indicators of the receptive state. Further, these markers are delayed in women with infertility and luteal phase deficiency. These studies illustrate the utility of IHC diagnosis for the evaluation of endometrial function.
导致母体与胎儿上皮细胞最初相互作用并进而确立妊娠的因素仍知之甚少。特定子宫内膜肽对卵巢甾体激素作出反应的时空表达，被认为有助于子宫接受期的形成，在此期间子宫内膜对植入的囊胚变得适宜。未能建立接受性可能是女性不育病例中很大一部分的原因，尤其影响黄体期缺陷、子宫肌瘤、子宫内膜异位症、习惯性流产和不明原因不孕的女性。此外，尽管全球在先进生殖技术方面的经验不断增加，但大多数体外受精（IVF）尝试仍未成功，最可能的原因是植入失败。在本文中，我们回顾了人类子宫接受性研究中涉及的概念，强调了最近发现的潜在免疫组织化学（IHC）标志物，并讨论了子宫内膜的免疫组织化学评估如何成为评估接受性子宫内膜状态的一种潜在有价值的方法。采用这种方法，我们研究了几种子宫接受性的新潜在标志物。子宫内膜孕酮受体和整合素细胞粘附分子之一在植入前后似乎会发生表达变化，可能是接受状态的敏感指标。此外，这些标志物在不育和黄体期缺陷的女性中出现延迟。这些研究说明了免疫组织化学诊断在评估子宫内膜功能方面的实用性。
