Establishment and of effective mechanical stimulation of the endometrium to improve implantation based on elucidation of the mechanism

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K09762
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56040:Obstetrics and gynecology-related
• Research Institution: Keio University
• Principal Investigator: Uchida Hiroshi 慶應義塾大学, 医学部(信濃町), 講師 (90286534)
• Co-Investigator(Kenkyū-buntansha): 丸山 哲夫 慶應義塾大学, 医学部(信濃町), 准教授 (10209702) ; 内田 明花 慶應義塾大学, 医学部(信濃町), 講師 (60445236)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: implantation

Outline of Final Research Achievements

About 70% of all IVF failures are due to pregnancy failure after embryo transfer. Therefore, intentional intrauterine manipulation has been performed prior to transfer to improve the success rate, but the mechanism of this effect has remained unclear. It has been assumed that the receptivity of the endometrium is enhanced by an increase in local metabolism due to an immediate restorative action in response to abrasion-induced destruction. This study revealed that the endosolutesis of the endometrial epithelial cells (and a part of stromal cells) leaked by apoptosis of cells initiated by the adhesion of the embryo, supports the adhesive and invasion ability of the embryo, furthermore, the endometrial cell solution enhances the efferent cell movement that restores the embryonic invasion route.

Free Research Field

reproduction

Academic Significance and Societal Importance of the Research Achievements

生殖補助医療において、妊娠率向上のために胚移植前に実施される子宮内膜擦過術は、その機序は不明であった。これまでは擦過による破壊に対する即応的な修復作用により局所的な代謝が上昇することで子宮内膜の受容能が高まると想像されていたが、本研究により、その機序の一旦は胚接着を合図に始まる子宮内膜細胞の細胞死によって表出する細胞内溶液が胚の接着、侵入および、侵入後の子宮内膜組織の修復にまで支援的に働くことによることが明らかとなった。