Objective:To investigate the relationship between positive expression of multiple myeloma oncogene 1 (MUM1) and changes of endometrial endometrium in patients with repeated implantation failure (RIF).Methods:A retrospective cohort study of 62 RIF patients who attended the Center for Reproductive Medicine of the Second Affiliated Hospital of Zhengzhou University between March 2022 and May 2023 were selected. All patients were examined by perimetry, endometrial tissue was collected, and the positive expression of MUM1, vascular endothelial growth factor (VEGF), and microvessel density (MVD) were detected by immunohistochemical staining. The endometrial hemodynamics were examined by three-dimensional Doppler ultrasound, and according to the results of MUM1 expression, the patients were divided into MUM1-positive group (29 cases) and MUM1-negative group (33 cases). The endometrial thickness, endometrial blood flow vascularization index (VI), flow index (FI), vascularized blood flow index (VFI), and bilateral uterine arterial blood flow resistance index (RI), pulsatility index (PI), peak systolic velocity/peak diastolic velocity (S/D) were compared between the two groups. The expression levels of endometrial VEGF and MVD were compared between the two groups. Pearson correlation was used to explore the correlation between the expression of endometrial VEGF, MVD and endometrial blood flow VI, FI, VFI in the two groups.Results:In RIF patients, the endometrial VEGF positivity rate [31.03% (9/29)], MVD expression (16.97±3.28), and endometrial VI (1.45±0.96), FI (21.13±5.33), and VFI (0.39±0.17) in MUM1-positive group were significantly lower than those in the MUM1-negative group [the VEGF-positive rate: 36.36% (12/33), P<0.001; MVD: 33.42±7.97, P<0.001; VI: 1.91±0.56, P=0.025; FI: 23.91±5.37, P=0.045; VFI: 0.54±0.14, P=0.004]. Bilateral uterine arterial blood flow RI (0.69±0.14), PI (1.49±0.61), S/D (2.40±0.62) in MUM1-positive group was significantly higher than those in MUM1-negative group (0.54±0.15, 0.92±0.34, 1.45±0.40; all P<0.001). There was a significant positive correlation between the endometrial MVD expression level in the MUM1-positive group and endometrial blood flow of VI, FI, and VFI ( r=0.931, P<0.001; r=0.968 , P<0.001; r=0.914, P<0.001), and there was also a significant positive correlation between endometrial VEGF expression and endometrial blood flow VI, FI, and VFI ( r=0.965 , P<0.001; r=0.954, P<0.001; r=0.935, P<0.001). Conclusion:In RIF patients, the positive expression of MUM1 affects endometrial blood flow and the expression levels of VEGF and MVD, and there is a significant positive correlation between endometrial blood flow VI, FI, VFI and the expression of VEGF and MVD in the endometrium.

Objective:To investigate the relationship between positive expression of multiple myeloma oncogene 1 (MUM1) and changes of endometrial endometrium in patients with repeated implantation failure (RIF).Methods:A retrospective cohort study of 62 RIF patients who attended the Center for Reproductive Medicine of the Second Affiliated Hospital of Zhengzhou University between March 2022 and May 2023 were selected. All patients were examined by perimetry, endometrial tissue was collected, and the positive expression of MUM1, vascular endothelial growth factor (VEGF), and microvessel density (MVD) were detected by immunohistochemical staining. The endometrial hemodynamics were examined by three-dimensional Doppler ultrasound, and according to the results of MUM1 expression, the patients were divided into MUM1-positive group (29 cases) and MUM1-negative group (33 cases). The endometrial thickness, endometrial blood flow vascularization index (VI), flow index (FI), vascularized blood flow index (VFI), and bilateral uterine arterial blood flow resistance index (RI), pulsatility index (PI), peak systolic velocity/peak diastolic velocity (S/D) were compared between the two groups. The expression levels of endometrial VEGF and MVD were compared between the two groups. Pearson correlation was used to explore the correlation between the expression of endometrial VEGF, MVD and endometrial blood flow VI, FI, VFI in the two groups.Results:In RIF patients, the endometrial VEGF positivity rate [31.03% (9/29)], MVD expression (16.97±3.28), and endometrial VI (1.45±0.96), FI (21.13±5.33), and VFI (0.39±0.17) in MUM1-positive group were significantly lower than those in the MUM1-negative group [the VEGF-positive rate: 36.36% (12/33), P<0.001; MVD: 33.42±7.97, P<0.001; VI: 1.91±0.56, P=0.025; FI: 23.91±5.37, P=0.045; VFI: 0.54±0.14, P=0.004]. Bilateral uterine arterial blood flow RI (0.69±0.14), PI (1.49±0.61), S/D (2.40±0.62) in MUM1-positive group was significantly higher than those in MUM1-negative group (0.54±0.15, 0.92±0.34, 1.45±0.40; all P<0.001). There was a significant positive correlation between the endometrial MVD expression level in the MUM1-positive group and endometrial blood flow of VI, FI, and VFI ( r=0.931, P<0.001; r=0.968 , P<0.001; r=0.914, P<0.001), and there was also a significant positive correlation between endometrial VEGF expression and endometrial blood flow VI, FI, and VFI ( r=0.965 , P<0.001; r=0.954, P<0.001; r=0.935, P<0.001). Conclusion:In RIF patients, the positive expression of MUM1 affects endometrial blood flow and the expression levels of VEGF and MVD, and there is a significant positive correlation between endometrial blood flow VI, FI, VFI and the expression of VEGF and MVD in the endometrium.