Tekrarlayan i̇mplantasyon başarisizliği olan hastalarda endometriumda oluşturulan lokal hasarlanma etkilerinin işik ve elektron mikroskobik i̇ncelenmesi

In spite of good quality embryo transfer, the failure in successful conception in IVF treatment remains a major problem, whilst it is reported that local injury to the endometrium increases the implantation rate and viable pregnancy. Although a number of clinical studies have been carried out on the outcomes of endometrial local injury, the mechanisms that are involved in increasing implantation rate have not been elucidated. In this study, endometrial biopsies of local injury are performed on 8 women aged 25 to 35 years old with recurrent implantation failure who have undergone 21. day of their endometrial cycle. On the same day of the next menstrual cycle, the effects of local injury in the biopsy samples are assessed. The endometrial biopsies are embedded in paraffin for light microscopy and in Epon for electron microscopy once the processing is done. In paraffin sections, alterations in endometrial morphology are evaluated by hematoxylin and eosin staining while alterations in connective tissue components are determined by Masson trichrome staining. The localization and immunoreactivity of implantation markers LIF and LIF-R on the endometrial surface and in the endometrial glands are evaluated by immunochemistry. Thin sections from Epon blocks are assessed with the electron microscope in order to reveal cellular alterations in the ultrastructure of the endometrium. In our study, we observe an increase in LIF and LIF-R immunoreactivity of endometrial surface and gland epithelium. At the same time, ultrastructural differences are found after local injury in patients. These results indicate that local injury has positive effects on endometrial surface and gland epithelium for patients with recurrent implantation failure.