The endometrial factor in human embryo implantation

摘要: The studies presented in this thesis aimed to explore the role of endometrium implantation process. At present, embryo is major rate-limiting step for success fertility treatment. Clinicians have sought develop clinical interventions at enhancing rates from IVF. As reviewed thesis, there no evidence supporting empirical use most pharmaceutical interventions, such as aspirin, nitric oxide, aromatase inhibitors, ascorbic acid, prolonged progesterone treatment, or insulin sensitizing drugs, an unselected IVF population. A meta-analysis RCTs on effect adjuvant glucocorticoids peri-implantation period was performed and showed higher pregnancy women undergoing (not ICSI) using borderline significance. For ethical practical reasons it difficult study human vivo, since many approaches will risk disturbing process itself. Endometrial secretion aspiration prior transfer analysis by a multiplex immunoassay non-invasive has been shown be safe clinically useful approach endometrial factor implantation. We that cytokine profiling identifies profile conducive pregnancy, ability predict interleukin (IL)-1? Tumor Necrosis Factor (TNF)-? levels secretions similar additive predictive value quality. Supraphysiological sex steroid resulting ovarian stimulation are considered detrimental receptivity Significantly concentrations IL-1 IL-5, IL-10, IL-12, IL-17, TNF-?, Heparin-binding Epidermal Growth (Hb-EGF), Eotaxin, Dickkopf homolog (Dkk)-1 were present obtained stimulated compared natural cycles. There may impaired pathogenic effects bacterial vaginosis. intra-uterine with without vaginosis assessed which within normal range controls, tendency more pro-inflammatory profile. Previous investigate generally relied individual candidate genes. To date single marker identified specific sensitive identifying receptive though. Microarray enables global genomic perspective. Results largest set microarray data transcriptome idiopathic recurrent failure versus controls reported. Dysregulated pathways meriting further investigation. Concerning general population, we believe can conclude important determinant not simply facilitory. However, diminished primary cause only limited number patients, who cannot easily known parameters gene expression test remains elusive.