In order to study the angiogenesis in endometriosis, the samples of eutopic and ectopic endometria from patients with endometriosis were quantitatively analyzed by color morphometric image system (CMIS) for vascular surface area, and by examining endometrial blood vessel for microvessel density (MVD). The results showed that within each menstrual phase the vascular surface area and MVD were significantly higher in ectopic endometria with endometriosis than those in eutopic endometria with endometriosis or normal endometrium (P < 0.05). It is concluded that angiogenesis might be involved in the development of endometriosis.
Endometriosis/etiology ; Endometriosis/*pathology ; Endometrium/*blood supply ; Menstrual Cycle ; *Neovascularization, Pathologic ; *Pelvis

In order to study the angiogenesis in endometriosis, the samples of eutopic and ectopic endometria from patients with endometriosis were quantitatively analyzed by color morphometric image system (CMIS) for vascular surface area, and by examining endometrial blood vessel for microvessel density (MVD). The results showed that within each menstrual phase the vascular surface area and MVD were significantly higher in ectopic endometria with endometriosis than those in eutopic endometria with endometriosis or normal endometrium (P < 0.05). It is concluded that angiogenesis might be involved in the development of endometriosis.
Adult ; Endometriosis ; etiology ; pathology ; Endometrium ; blood supply ; Female ; Humans ; Menstrual Cycle ; Neovascularization, Pathologic ; Pelvis

OBJECTIVE: To observe the effect of warming acupuncture on uterine blood perfusion in the patients with failed high-quality freeze-thawed embryo transfer (FET) and explore its effect mechanism on the improvement of clinical pregnancy rate after re-tranfer. METHODS: A total of 72 patients of failed high-quality FET were randomized into an observation group and a control group, 36 cases in each one. In the observation group, after the menstrual period ended, warming acupuncture started at the acupoints located on the abdomen, e.g. Qihai (CV 6), Guanyuan (CV 4), Zhongji (CV 3) and Qugu (CV 2) and those on the lumbar sacral region, e.g. Shenshu (BL 23), Mingmen (GV 4) and Yaoyangguan (GV 3), 50 min in each treatment, once daily, at the interval of 1 day after 4-day treatment. The treatment was discontinued till the patients were at the ovulatory stage. In the control group, capsules were taken orally and continuously after the end of menstrual period, 3 capsules each time, three times a day and stopped at the ovulatory stage. The treatment of one menstrual cycle was taken as one course and the treatment for 3 menstrual cycles was required. Before and after treatment, the uterine artery pulsation index (PI), endometrial thickness, endometrial type, uterine blood perfusion, the recovery time of sufficient uterine blood flow, the endomentrial receptivity (ER) during the implantation window period and the clinical pregnancy rate were observed in the two groups. RESULTS: After treatment, the endometrial thickness was increased and PI decreased obviously in the two groups (<0.05) and PI in the observation group was lower than that in the control group (<0.05). After treatment, the proportion of type a and type A of endometrium was increased markedly in the two groups (<0.05) and the proportion in the observation group was higher than the control group (<0.05). After treatment, the case proportion of sufficient uterine blood flow was increased obviously in the two groups (<0.05) and the value in the observation group was higher than the control group [83.3% (30/36) vs 69.4% (25/36), <0.05]. After treatment, the proportion of ER during the implantation window period was increased remarkably in the two groups (<0.05) and the value in the observation group was higher than the control group [72.2% (26/36) vs 50.0% (18/36), <0.05]. The recovery time of sufficient uterine blood flow in the observation group was shorter than the control group (<0.05) and the clinical pregnancy rate was higher than the control group [47.2% (17/36) vs 33.3% (12/36), <0.05]. CONCLUSION Warming acupuncture enhances uterine blood perfusion and improves uterine endometrial receptivity so that the clinical pregnancy rate is increased after re-transfer in the patients with failed high-quality freeze-thawed embryo transfer.
Acupuncture Points ; Acupuncture Therapy ; Embryo Transfer ; Endometrium ; Female ; Humans ; Pregnancy ; Pregnancy Rate ; Uterus ; blood supply

In order To evaluate whether the parameters of spiral artery blood flow, as measured by transvaginal color Doppler, may be used to assess endometrium receptivity prior to embryo transfer (ET), a retrospective study of 94 infertile women who had undergone ART treatments with different outcomes (pregnant or nonpregnant) was done. Subendometrial blood flow was evaluated. The resistance index (RI), systolic/diastolic ratio (S/D) and pulsatility index (PI) were significantly lower in those who achieved pregnancy as compared with those who did not: 0.62+/-0.04 vs 0.68+/-0.04 (P<0.001), 2.66+/-0.33 vs 3.19+/-0.39 (P<0.01) and 1.15+/-0.17 vs 1.34+/-0.22 (P<0. 05), respectively. Furthermore, when RI>0. 2, PI>1. , and S/D>3. , no pregnancy occurred. These data suggest that the parameters of spiral artery blood flow could be used as a new assay in predicting endometrial receptivity before ET.
Arteries/ultrasonography ; Embryo Implantation/*physiology ; Embryo Transfer ; Endometrium/*blood supply ; Endometrium/*physiology ; Endometrium/ultrasonography ; Fertilization in Vitro ; Infertility, Female/physiopathology ; Regional Blood Flow ; Sperm Injections, Intracytoplasmic ; Treatment Outcome ; Ultrasonography, Doppler, Color

OBJECTIVE: To evaluate the effect of manual acupuncture on endometrial blood flow parameters by three-dimensional (3D) power Doppler ultrasound in women undergoing in vitro fertilization embryo transfer (IVF-ET). METHODS: Seventy patients undergoing IVF-ET were equally randomized into traditional or sham acupuncture treatment group for totally 4 days (from the day of oocyte aspiration to the day of embryo transfer) of treatment by random envelope method at the Reproductive Medicine Center and Outpatient Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology from January 2013 to December 2015. Patients in the traditional acupuncture group accepted traditional acupuncture methods with manual acupuncture, and Zhongji (CV3), Qihai (CV 6), Sanyinjiao (SP6), Taichong (LR 3), Tianshu (ST 25), Guilai (ST 29) and Zusanli (ST 36) were chosen. Patients at the sham acupuncture group accepted shallow acupuncture methods at 4 non-meridian points at each shoulder and upper arm. Outcome measures included endometrial ultrasonic indices such as vascularization index (VI), flow index (FI) and vascularization flow index (VFI), endometrial thickness and volume, subendometrial VI (sVI), subendometrial FI (sFI), subendometrial VFI (sVFI), implantation rate, clinical pregnancy rate, abortion rate, live birth rate and number of live births. RESULTS: Finally, 34 patients in the traditional acupuncture group and 35 in the sham acupuncture group completed this trial. VI, FI and VFI of the traditional acupuncture group were significantly higher than those in the sham acupuncture group (P<0.05). No significant differences were found in endometrial thickness, endometrial volume, sVI, sFI, sVFI, implantation rate, clinical pregnancy rate, abortion rate, live birth rate and number of live births (P>0.05). CONCLUSIONS Manual acupuncture performed after oocyte aspiration and before transplantation improved the endometrial blood flow parameters VI, RI and VFI in women who underwent IVF-ET, instead of sVI, sFI and sVFI. Therefore, acupuncture might be beneficial in women undergoing IVF-ET by increasing endometrial blood flow and endometrial receptivity. (Registration No. ChiCTR2100053354).
Pregnancy ; Humans ; Female ; Fertilization in Vitro/methods* ; Single-Blind Method ; Embryo Transfer ; Pregnancy Rate ; Acupuncture Therapy ; Endometrium/blood supply*

Placenta is an important organ to maintain fetal growth, metabolism, maternal and fetal physiologic balance. Angiogenesis is a critical factor in placental development involved in fetal blood circulation and vascular changes in the endometrium and placenta. Angiogenesis is closely related to angiogenesis factors such as vascular endothelial growth factor and placenta growth factor. Fetal growth restriction threats the fetal health in gestation and also increases the long-term likeliness of several diseases. In this review, the authors summarize the findings in current studies of the relationship between angiogenesis factors and fetal growth restriction.
Angiogenesis Inducing Agents ; metabolism ; Endometrium ; blood supply ; Female ; Fetal Development ; Fetal Growth Retardation ; Humans ; Neovascularization, Physiologic ; Placenta ; blood supply ; Placenta Growth Factor ; Pregnancy ; Pregnancy Proteins ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVETo evaluate the value of endometrial microvessel density (MVD) in assessing the endometrial receptivity during the peri-implantation period.

METHODSA total of 104 patients undergoing in vitro fertilization and embryo transfer (IVF-ET) treatment were analyzed retrospectively. The subjects were divided into clinical pregnancy group (50 cases) and nonpregnant group (54 cases) according to the IVF-ET outcome. Endometrial tissues were collected 7 days after the natural ovulation prior to IVF-ET for measurement of the endometrial MVD using electron microscopy, which was analyzed in relation to the clinical outcome of the treatment.

RESULTSThe endometrial MVD was significantly higher in the clinical pregnancy group than in the nonpregnant group [(4.12∓1.84)% vs (3.46∓1.26)%, t=-2.127, P=0.036). ROC curve analysis showed that the MVD had an area under the curve slightly over 0.5 (0.598) for predicting clinical pregnancy, suggesting a poor specificity in predicting the clinical outcome of the treatment.

CONCLUSIONIn IVF-ET cycles, the endometrial MVD during the peri-implantation period is helpful for assessing the endometrial receptivity, but the specificity remains low.

Adult ; Embryo Implantation ; physiology ; Embryo Transfer ; Endometrium ; blood supply ; physiology ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; diagnostic imaging ; physiopathology ; therapy ; Microvessels ; ultrastructure ; Retrospective Studies ; Ultrasonography

OBJECTIVETo investigate the expression of aquaporin 1 (AQP1) in endometrium of patients with menorrhagia.

METHODSRT-PCR and immunohistochemistry were carried out in twenty women with normal menstrual cycle to confirm the expression of AQP1 in endometrium and locate it. Then 51 women with menorrhagia and 40 women with normal menstrual cycle were included in the study. RT-PCR and immunohistochemistry were used to examine the expression of AQP1.

RESULTAQP1 mRNA was expressed in the human endometrium throughout menstruation cycle, which was mainly located in the endothelia of the capillaries and small blood vessels. Quantification of the immunostaining revealed higher density during secretary phase than that in proliferative phase (P<0.01). The staining intensity and density of AQP1-positive microvessel decreased significantly in simple hyperplasia group (P<0.01) and then gradually increased in complex hyperplasia and atypical hyperplasia groups (P<0.001).

CONCLUSIONDecreased expression of AQP1 may lead to disturbed endometrial vascular remodeling and may be involved in the occurrence of menorrhagia.

Adult ; Aquaporin 1 ; biosynthesis ; genetics ; Endometrium ; blood supply ; metabolism ; Female ; Gene Expression ; Humans ; Immunohistochemistry ; Menorrhagia ; genetics ; metabolism ; pathology ; RNA, Messenger ; biosynthesis ; genetics ; Reverse Transcriptase Polymerase Chain Reaction

BACKGROUNDDirect and indirect evidences have suggested that angiogenesis is a prerequisite for the development of endometriosis. Aiming at offering experimental evidences for anti-angiogenesis therapy, we transplanted the eutopic endometrium from patient with endometriosis into the severe combined immunodeficiency disease (SCID) mice, to evaluate the effect of the endostatin on the growth and angiogenesis of the established endometriosis lesions in SCID mice model.

METHODSEutopic endometrium of women with endometriosis was transplanted into the SCID mice. The mice were randomized into treatment (n = 10) and control groups (n = 10). Two weeks after the implantation of endometrium fragment, the treatment group was injected with recombinant human endostatin YH-16 into the peritoneal cavity (2 mgxkg(-1)xd(-1)), whereas the control group received equivalent volume of PBS (200 microl/d). The volume of endometriotic lesions in SCID mice was measured every three days, and all the treatment lasted for 14 days. Immunohistochemistry was used to determine microvessel density (MVD) and the expression of VEGF. The results were analyzed by t test and chi(2) test to value the treating effect.

RESULTSCompared with the control group, growth of endometriosis lesion was reduced in the mice treated with YH-16. Statistically significant differences in the volume and weight of the ectopic lesions were observed between the treatment and the control groups (P < 0.05). Microscopical examination showed that after being treated with YH-16, the volume of the endometrial tissues decreased, the glands depauperated, and the glandular epithelium partially degenerated. Necrotic debris was observed in the endometrial stroma. MVD and expression of VEGF in the treatment group were significantly lower than those in the control group (P < 0.05).

CONCLUSIONSRecombinant human endostatin affects the maintenance and growth of endometriotic tissues by inhibiting angiogenesis and reducing the expression of VEGF in ectopic lesion. The angiostatic agent may be promising as a therapy for endometriosis.

Adult ; Angiogenesis Inhibitors ; therapeutic use ; Animals ; Disease Models, Animal ; Endometriosis ; drug therapy ; pathology ; physiopathology ; Endometrium ; blood supply ; Endostatins ; therapeutic use ; Female ; Humans ; Mice ; Mice, SCID ; Middle Aged ; RNA, Messenger ; analysis ; Recombinant Proteins ; therapeutic use ; Vascular Endothelial Growth Factor A ; analysis ; genetics