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대한생식의학회지 제30권 제1호 2010년
황체기 결함이 있는 불임환자에서 클로미펜 투여 여부에 따른 자궁내막 내의 Prolactin의 발현 양상의 비교 연구
인제대학교 의과대학 산부인과학교실, 한양대학교 의과대학 산부인과학교실, 병리학교실
고승희, 황정혜,심의섭,고재환,김용봉,장세진
Comparison of Expression of Endometrial Prolactin in Infertile Women with Luteal Phase Defect According to Clomiphene Citrate Administration
Goh SH
Department of Obstetrics and Gynecology, School of Medicine, Inje University, Department of Obstetrics & Gynecology, Pathology, School of Medicine, Hanyang University, Seoul, Korea
Objective: Clomiphene citrate is one of the most commonly used drugs in the treatment of infertility, but the pregnancy rate achieved with clomiphene citrate is significantly lower than the ovulation rate due to its antiestrogenic effect on the endometrium. Endometrial prolactin is considered to be a marker and an inducer of predecidualization that is characteristic of secretory endometrium. The purpose of this study was to evaluate the association of clomiphene citrate and unsatisfactory endometrial differentiation to secretory endometrium by examining the endometrial expression of prolactin in clomiphene citrate- treated infertile women with luteal phase defect. Methods: The endometrial samples from infertile women with luteal phase defect (n=27) were examined. Five cases during secretory phase and six cases during proliferative phase were obtained by biopsy. Sixteen cases were obtained by biopsy during secretory phase after clomiphene citrate treatment. By immunohistochemical staining for prolactin, all obtained endometrial tissues were examined. The differences in the endometrial expression of prolactin were evaluated between proliferative phase and secretory phase, and between clomiphene citrate treated group and no treatment group during secretory phase. Results: The staining of endometrial prolactin was significantly more intense in the glandular epithelial cells and stromal cells in the secretory endometrium than in the proliferative endometrium. The glandular expression of prolactin in the secretory endometrium was not significantly different between the clomiphene citrate-treated group and no treatment group (p=0.719), but the staining of prolactin in the stromal cells was significantly less intense in the clomiphene citrate-treated group than no treatment group (p=0.019). Conclusion: In this investigation, we demonstrated that the endometrial stromal expression of prolactin in the secretory phase was significantly lower in the clomiphene citrate-treated group campared with no treatment group in infertile women with luteal phase defect. And our finding suggests that clomiphene citrate may have an adverse effect on the endometrial predecidualization in infertile women.
키워드 : Endometrial prolactin, Clomiphene citrate, Luteal phase defect
교신저자 : kimyb2@unitel.co.kr
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