Predictive value of endometrial receptivity evaluated by three-dimensional ultrasound in ectopic pregnancy after in vitro fertilization-embryo transfer

OBJECTIVE

The aim of this study was to use three-dimensional (3D) ultrasound to detect ultrasound parameters related to the uterine artery and endometrium, evaluate endometrial receptivity, and investigate the predictive value of each parameter for ectopic pregnancy (EP) after in vitro fertilization-embryo transfer (IVF-ET).

PATIENTS AND METHODS

Fifty-seven cases of pregnancy following IVF-ET in our institution were collected and split into EP and intrauterine pregnancy (IP) groups based on the location of pregnancy, with 27 cases in EP and 30 cases in IP. Endometrial thickness, type, volume, endometrial blood flow parameters, and uterine artery blood flow parameters were all measured one day before transplantation in both groups, and the differences between the two groups were examined.

RESULTS

There were differences in endometrial blood flow typing between the two groups, with type III endometrium accounting for the highest proportion in both; the uterine spiral artery pulsatility index PI was significantly higher in the EP group than in the IP group; there were no statistical differences in uterine volume, uterine artery resistance index mRI, or uterine artery resistance index S/D between the two groups; there were no statistical differences in uterine volume, or uterine artery.

CONCLUSIONS

Intracavitary 3D ultrasound can assess endometrial tolerance and may predict pregnancy outcome after IVF-ET.

[Study on the changes of gonadotropin releasing hormone agonist in pinopodes]

Objective: To study the changes of gonadotropin releasing hormone agonist (GnRH-a) in pinopodes during luteal phase and to explore the possible mechanism of GnRH-a in luteal phase support of assisted reproductive technology (ART). Methods: Totally 40 primary infertility women who were treated with ART due to male factors were enrolled, according to the order of the group they were randomly divided into experimental group and control group. On the 7th day after ovulation, the experimental group received a subcutaneous injection of 0.1 mg of GnRH-a, while the control group received a subcutaneous injection of placebo only (0.9% saline 2 ml), 3 days later they came to the clinic again. Serum estradiol and progesterone levels were measured before and after treatment in each group. Pinopodes were collected for electron microscopic examination. Levels of ER and PR were detected by western blot. Results: (1) There was no significant difference between the experimental group and the control group in the estrogen level before and after the treatment (all P>0.05). The level of progesterone in the experimental group after treatment [(66.8±14.9) nmol/L] was significantly higher than that before treatment(P<0.05); also significantly higher than the same period of the control group (P<0.05). (2) There was no significant difference in the expression of ER protein in the experimental group before and after treatment (P>0.05). The expression of PR in the experimental group after treatment was significantly lower than that before treatment (P<0.05); also lower than the same period of the control group (P<0.05). (3) Expression amount of pinopodes in the experimental group after treatment was significantly higher than that before treatment [65% (13/20) versus 25% (5/20), P<0.05], and the development trend was more mature [the percentage of maturation:75% (15/20) versus 35% (7/20), P<0.05]. Expression amount of pinopodes after treatment and the percentage of maturation in the experimental group were significantly higher than those in the same period of control group (P<0.05). Conclusion: GnRH-a in luteal phase support may play a role through the corpus luteum, which may promote the secretion of progesterone, downregulation of PR expression, promote the growth of pinopodes, and improve the endometrial receptivity.

Deep innervation of sural nerve

Discharges of 37 sural afferents in the A alpha to C fiber range have been recorded during stimulation of subcutaneous tissues after removal of the skin. Except for one A alpha unit with muscle spindle properties, fibers were not easily excited by muscle stretching. The more slowly conducting fibers tended to have higher thresholds. After repeated stimulation, most A delta and C units displayed a persistent afterdischarge which lasted from several minutes to more than half an hour.