Local injury to the endometrium in controlled ovarian hyperstimulation cycles improves implantation rates.
OBJECTIVE
To explore the possibility that local injury to the endometrium in controlled ovarian hyperstimulation cycle improves the incidence of embryo implantation and to analyze the gene expression profile in the endometria of pregnant and nonpregnant patients in in vitro fertilization/embryo transfer (IVF-ET).


METHODS
Prospective study.


METHODS
A clinical assisted reproductive center of a university hospital.


METHODS
Women undergoing fresh IVF-ET cycles (n = 121), treated with a long protocol for controlled ovarian hyperstimulation, whose endometrium were diagnosed by B-ultrasound showing irregular echo.


METHODS
Local injury to the endometrium of 60 patients in controlled ovarian hyperstimulation cycle, who were randomly selected from a total of 121 patients. Seven endometrial biopsies samples from day 10 were analyzed by Affymetrix U133 plus 2.0 gene chip.


METHODS
Outcomes of IVF-ET and gene expression assayed by gene chip technology.


RESULTS
Transfer of the same number of embryos (135 in the experimental and control patients, respectively) resulted in rates of implantation (33.33% vs. 17.78%), clinical pregnancy (48.33% vs. 27.86%), and ongoing or live births per ET (41.67% vs. 22.96%) that were higher in the experimental group compared with controls. Statistically significant differences of the expression level of 218 genes (41 up-regulated and 177 down-regulated) were detected in the endometrial biopsy samples from clinical pregnant patients and nonpregnant patients.


CONCLUSIONS
The results suggested local injury to the endometrium during a COH cycle improved the rates of embryo implantation, clinical pregnancy and live birth in ART. We also demonstrated a statistically significant difference in the messenger RNA (mRNA) expression profiles in the endometrium of pregnant and nonpregnant patients. Further studies on the genes identified herein will assist in predicting implantation competence.
Department of Reproductive Medicine, Peking University Shenzhen Hospital, Medical Central of Peking University and Hong Kong Science and Technology University, Shenzhen, Guangdong, People's Republic of China.
Liang
L
Zhou
Department of Reproductive Medicine, Peking University Shenzhen Hospital, Medical Central of Peking University and Hong Kong Science and Technology University, Shenzhen, Guangdong, People's Republic of China. Electronic address: lrivf@163.com.
Rong
R
Li
Department of Reproductive Medicine, Peking University Shenzhen Hospital, Medical Central of Peking University and Hong Kong Science and Technology University, Shenzhen, Guangdong, People's Republic of China.
Rong
R
Wang
Department of Reproductive Medicine, Peking University Shenzhen Hospital, Medical Central of Peking University and Hong Kong Science and Technology University, Shenzhen, Guangdong, People's Republic of China.
Hai-Xiong
HX
Huang
Department of Reproductive Medicine, Peking University Shenzhen Hospital, Medical Central of Peking University and Hong Kong Science and Technology University, Shenzhen, Guangdong, People's Republic of China.
Kai
K
Zhong
D000328:Adult; D001706:Biopsy; D015536:Down-Regulation / Q000235:genetics / Q000502:physiology; D010064:Embryo Implantation / Q000235:genetics / Q000502:physiology*; D004624:Embryo Transfer / Q000379:methods; D004717:Endometrium / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D020869:Gene Expression Profiling; D006801:Humans; D020411:Oligonucleotide Array Sequence Analysis; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D012333:RNA, Messenger / Q000378:metabolism; D014463:Ultrasonography; D015854:Up-Regulation / Q000235:genetics / Q000502:physiology
D012333:RNA, Messenger