Evaluation of endometrial receptivity by immunohistochemistry, scanning electron microscopy and optical coherence tomography

Ph.D. ; Implantation is essential for successful pregnancy. It is estimated that two-thirds of infertility are resulted from implantation failure. A successful implantation needs three basic factors: a viable embryo, a receptive endometrium and the synchronous development between those two. Up to data, even though pregnancy rate is increased significantly in assisted reproductive technology (ART) by new embryo selection techniques, there is no technique which improves embryo quality. How to efficiently evaluate endometrial receptivity becomes crucial for clinicians to treat infertility. ; During implantation window, endometrium undergoes a complex sequence of physical and biological events to become receptive to embryo. Numbers of molecules and morphological parameters have been proposed as potential makers for endometrial receptivity, however, each marker may only reflect one aspect of the development. Few studies combined morphological markers together. The main aim of this study is to examine and compare molecular, morphological and histological receptive markers’ condition in peri-implantation endometrium in women with reproductive failure, including recurrent implantation failure (RIF) and recurrent miscarriage (RM). The relationship between the markers have also been explored. ; In the first part of the study, we evaluated mucin 1 (MUC1), leukemia-inhibitory factor (LIF) and integrin ß3 expression level in endometrium by immunohistochemistry. The results showed that MUC1, but not LIF and integrin ß3, was significantly decreased in both luminal and glandular epithelium in women with RIF, but not in women with fertile and RM. Both LIF and integrin ß3 do not appear to be sensitive receptivity markers when compared to MUC1. In addition, the reduction in MUC1 expression was an independent marker of endometrial receptivity in women with RIF. ; In the second part of the study, we evaluated pinopode and ciliated cells in luminal epithelium by scanning electron microscopy and scanning immunoelectron microscopy. We ...