Hysteroscopic Appearence of Midsecretory Endometrium in Relation to Pinopodes Expression and the Reproductive Outcome in Infertile Women

Objective To investigate the relation between hysteroscopic finding and pinopodes expression, meanwhile to explore whether hysteroscopic finding was a predictor of reproductive outcome for infertile women. Methods A total of 79 infertile patients underwent hysteroscopic assessement of the midsecretory endometrium and hormonal measurement 7-9 d after a spontaneous ovulation assessed with transvaginal ultrasound. Pinopodes expression by scanning electron microscope was examined simultaneously in randomly selected 32 patients. All patients were followed up to determine their reproductive outcomes. Results Twenty-six (32.9%) patients were diagnosed as having ‘good’ midsecretory endometrium and 53 (67.1%) as ‘poor’ midsecretory endometrium by hysteroscopy. There were no significant differences of endometrial thickness and pattern in the ‘good’ group compared with the ‘poor’ group. Serum progesterone level in the ‘good’ group was apparently higher than that in the ‘poor’ group (P=0.025), but no correlation was observed between serum oestradiol level and hysteroscopic finding. Significant differences of the development stage and number of pinopodes were observed between the two groups (P Conclusion The hysteroscopic appearance of the midsecretory endometrium is associated with serum progesterone level and pinopodes expression, which provides prognostic information with regard to the reproductive outcome of infertile women.

[1]  H Masamoto,et al.  Hysteroscopic appearance of the mid-secretory endometrium: relationship to early phase pregnancy outcome after implantation. , 2000, Human reproduction.

[2]  Chi-Huang Chen,et al.  Increased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization-embryo transfer. , 2005, Fertility and sterility.

[3]  P. Devroey,et al.  The role of the endometrium and embryo in human implantation. , 2007, Human reproduction update.

[4]  J. Ordi,et al.  Endometrial Pinopode and αvβ3 Integrin Expression Is Not Impaired in Infertile Patients with Endometriosis , 2003, Journal of Assisted Reproduction and Genetics.

[5]  G. Nikas,et al.  Uterine Pinopodes in Peri‐implantation Human Endometrium Clinical Relevance , 1997, Annals of the New York Academy of Sciences.

[6]  B. Fauser,et al.  The feasibility of a less invasive method to assess endometrial maturation—comparison of simultaneously obtained uterine secretion and tissue biopsy , 2009, BJOG : an international journal of obstetrics and gynaecology.

[7]  K. Inafuku [Hysteroscopy in midluteal phase of human endometrium evaluation of functional aspect of the endometrium]. , 1992, Nihon Sanka Fujinka Gakkai zasshi.

[8]  D. Loutradis,et al.  Uterine pinopodes as markers of the 'nidation window' in cycling women receiving exogenous oestradiol and progesterone. , 1995, Human reproduction.

[9]  T Sakumoto,et al.  Hysteroscopic assessment of midsecretory-phase endometrium, with special reference to the luteal-phase defect. , 1992, Hormone research.

[10]  S. Bassil Changes in endometrial thickness, width, length and pattern in predicting pregnancy outcome during ovarian stimulation in in vitro fertilization , 2001, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[11]  M. Fritz,et al.  Temporal and morphologic characteristics of pinopod expression across the secretory phase of the endometrial cycle in normally cycling women with proven fertility. , 2003, Fertility and sterility.

[12]  L. Nardo,et al.  Pinopode expression during human implantation. , 2002, European journal of obstetrics, gynecology, and reproductive biology.

[13]  P. Groothuis,et al.  Oestrogen and progestin responses in human endometrium , 2003, The Journal of Steroid Biochemistry and Molecular Biology.

[14]  H. Yarali,et al.  Assessment of endocervical and endometrial damage inflicted by embryo transfer trial: a hysteroscopic evaluation. , 2006, Reproductive biomedicine online.

[15]  G. Nikas Endometrial Receptivity: Changes in Cell-Surface Morphology , 2000, Seminars in reproductive medicine.

[16]  Mina Jafarabadi,et al.  Relationships between pregnancy rates following in vitro fertilization or intracytoplasmic sperm injection and endometrial thickness and pattern. , 2005, European journal of obstetrics, gynecology, and reproductive biology.

[17]  R. Casper,et al.  Pinopodes: a questionable role in endometrial receptivity. , 2008, Human reproduction update.

[18]  M. M. Singh,et al.  Endometrial receptivity: Clinical assessment in relation to fertility, infertility, and antifertility , 2006, Medicinal research reviews.

[19]  S. Dey,et al.  Adult tissue angiogenesis: evidence for negative regulation by estrogen in the uterus. , 2001, Molecular endocrinology.

[20]  T. Hannam,et al.  The presence of pinopodes in the human endometrium does not delineate the implantation window. , 2007, Fertility and sterility.

[21]  G. Nikas,et al.  Clinical value of endometrial pinopodes detection in artificial donation cycles. , 2004, Reproductive biomedicine online.

[22]  S. Fisher,et al.  Implantation and the survival of early pregnancy. , 2001, The New England journal of medicine.

[23]  A. Revel,et al.  Endometrial receptivity markers, the journey to successful embryo implantation. , 2006, Human reproduction update.

[24]  G. Nikas Pinopodes as markers of endometrial receptivity in clinical practice. , 1999, Human reproduction.

[25]  J. Bromer,et al.  Relationship between endometrial thickness and embryo implantation, based on 1,294 cycles of in vitro fertilization with transfer of two blastocyst-stage embryos. , 2007, Fertility and sterility.

[26]  M. Faramarzi,et al.  Endometrial thickness and pregnancy outcome after intrauterine insemination. , 2007, Fertility and sterility.

[27]  G. Doncel,et al.  Endometrial dating and determination of the window of implantation in healthy fertile women. , 2000, Fertility and sterility.