Korean J Fertil Steril.
1998 Apr;25(1):51-58.
Pinopode Development 2-days after Oocyte Retrieval in the Human IVF Patients
Abstract
- INTRODUCTION
There are three factors for successful implantation. These are embryo quality, uterine receptivity, and synchronization between embryonic and endometrial development. Despite remarkable progress in investigating embryos in human IVF, there has been slow progress in exploring the implantation process. It may be due to two reasons as follow. First, it is difficult to directly investigate the mechanism of implantation in the human, because of ethical considerations. Second, there is no sensitive and widely accepted marker for assessing endometrial development. Since the finding of a novel standard for dating endometrial biopsy by Noyes et. al.,. in 1950, there have been many attempts to identify suitable markers for uterine receptivity. Those include ultrasonographic changes (Ueno et.al., 1991; Grunfeld et al.,1991), three dimensional morphological changes of the endometrium such as pinopode formation (Market or alphaf., 1987; Mantel or alphaf., 1991; Nikas et al., 1995; Psychoyos & Nikas, 1994), integrin expression (Ilesanmi et al., 1993; Lessey et.al., 1992; Lessey, 1994), and measurement of endometrial proteins (Hell, 1986;Fay & Crudzinskas, 1991). Investigations in the rat (cartel et al., 1991)and human (cartel et al., 1987; Nikas et al., 1995; Psychoyos & Nikas, 1994) suggested the presence of pinopodes as a marker for the receptive phase.4 chronological barrier in uterine receptivity could be one of the major factors limiting IVF pregnancy rates. If we were able to manage the 'implantation window' we may be able to improve implantation and pregnancy rates in the human IVF program. In 1987, Martel et al., found early appearance of pinopodes in stimulated cycles for IVF compared to natural cycles in humans (Marcel et al., 1987). This effect was found in patients stimulated with clomephene citrate/hMG/hCG. The purpose of the present study was to evaluate the endometrial development in IVF patients stimulated with either by FSH/hMG/hCG or with GnRH agonist down regulation.
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