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Endometrial function at the preimplantation stage in women undergoing assisted reproduction technology cycles
Pubblicato su:
La Rivista Italiana di Ostetricia e Ginecologia n. 23
Abstract Objective: To evaluate endometrial function before embryo implantation in women undergoing assisted reproduction technology cycles (ART). Patients: Thirty-five infertile couples, divided into two groups with respect to reproductive outcome: 12 pregnant and 23 not pregnant. Main outcome measures: Serum leukemia inhibitory factor (LIF) , placental protein 14 ( PP14 ), cancer antigen 125 ( CA 125 ) , E2, and P; serum and follicular vascular endothelial growth factor (VEGF); resistance index, pulsatility index, and peak systolic velocity of the uterine, radial and follicular arteries. Results: The two groups were homogeneous for clinical, fertilization and color Doppler data. P, CA 125 and VEGF levels were comparable. E2 levels were significantly decreased (p=0,04 ) from the day of hCG administration to the day of embryo transfer only in the not-pregnant group ( from 1568±552 pg/ml to 1187±653 pg/ml ) . Serum P and PP14 levels were significantly increased ( p<0,05) from the day of ovum pick-up to transfer day in both groups. Serum PP14 in the pregnant group was significantly reduced (p<0,05) on pick-up day (0,91±0,78 ng/ml vs 2,39±2,28 ng/ml). Finally, serum LIF was significantly elevated (p<0,02) on pick-up day in the pregnant group (22,24±11,2 pg/ml vs 13,7±9,7 pg/ml). Conclusions: In conceptional cycles, during preimplantation stage, low PP14 and high LIF levels are the expression of enhanced immunosuppression and chemotaxis in the endometrium, making it more receptive to implantation.
Riassunto Objective: To evaluate endometrial function before embryo implantation in women undergoing assisted reproduction technology cycles (ART). Patients: Thirty-five infertile couples, divided into two groups with respect to reproductive outcome: 12 pregnant and 23 not pregnant. Main outcome measures: Serum leukemia inhibitory factor (LIF) , placental protein 14 ( PP14 ), cancer antigen 125 ( CA 125 ) , E2, and P; serum and follicular vascular endothelial growth factor (VEGF); resistance index, pulsatility index, and peak systolic velocity of the uterine, radial and follicular arteries. Results: The two groups were homogeneous for clinical, fertilization and color Doppler data. P, CA 125 and VEGF levels were comparable. E2 levels were significantly decreased (p=0,04 ) from the day of hCG administration to the day of embryo transfer only in the not-pregnant group ( from 1568±552 pg/ml to 1187±653 pg/ml ) . Serum P and PP14 levels were significantly increased ( p<0,05) from the day of ovum pick-up to transfer day in both groups. Serum PP14 in the pregnant group was significantly reduced (p<0,05) on pick-up day (0,91±0,78 ng/ml vs 2,39±2,28 ng/ml). Finally, serum LIF was significantly elevated (p<0,02) on pick-up day in the pregnant group (22,24±11,2 pg/ml vs 13,7±9,7 pg/ml). Conclusions: In conceptional cycles, during preimplantation stage, low PP14 and high LIF levels are the expression of enhanced immunosuppression and chemotaxis in the endometrium, making it more receptive to implantation. Key Words: IVF-ET, LIF, PP14,VEGF , endometrial function, , uterine artery Doppler velocimetry,, ART