目的:探讨不孕妇女宫腔镜下子宫内膜息肉(EP)样病变形态学特征,以提高宫腔镜诊断与组织病理学诊断的符合率.方法:选择2005年2月-2014年7月因不孕在广东省计划生育专科医院行宫腔镜检查者,其中EP样病变者进行宫腔镜下内膜形态学特点及组织病理学诊断的对比分析.结果:17.4％(1 372/7 884)的不孕妇女宫腔镜检查提示EP样病变.宫腔镜下EP样病变常见的形态学表现为:内膜赘生物、内膜局部隆起、内膜毛糙碎片多,所占比例依次为88.0％(1 207/1 372)、6.7％(92/1 372)和5.3％(73/1 372).经病理诊断检出率前3位依次为EP 83.0％(1 139/1 372)、EP样增生9.3％(128/1 372)、子宫肌瘤2.2％(31/1 372).宫腔镜下典型赘生物组宫腔镜与病理诊断符合率较无典型赘生物组高,差异有统计学意义(P＜0.05).多发性EP样赘生物占宫腔镜下EP样病变的77.8％(1 068/1 372),宫腔镜与病理诊断的符合率达98.0％(1 047/1 068).结论:宫腔镜下内膜有典型赘生物尤其多发性EP样赘生物者宫腔镜诊断与病理诊断符合率高.宫腔镜检查结合组织病理学检查可作为诊断子宫内膜病变的金标准.

目的:黄体中期宫腔镜检查对宫腔粘连分离术后内膜功能恢复的评估.方法:收集2009年10月至2014年3月在广东省计划生育专科医院宫腔镜中心进行宫腔粘连分离术治疗的宫腔粘连患者82例,术后于黄体中期(排卵后6～8天)行宫腔镜复查,宫腔形态恢复正常者根据宫腔镜下子宫内膜血管的形态和腺体开口分为内膜佳组与内膜差组.比较两组B超检查内膜厚度及分型,黄体中期血清雌二醇(E2)、孕酮(P)的水平,免疫组织化学技术检测子宫内膜雌激素受体(ER)、孕激素受体(PR)的表达,随访妊娠率及妊娠结局等.结果:①宫腔粘连分离术后复查宫腔形态满意72例,其中,内膜佳组49例,内膜差组23例.②内膜佳组排卵日、黄体中期B超检查内膜厚度分别为8.2±1.0mm、8.0±0.8mm,较内膜差组7.1±1.2mm、7.0 ±1.0 mm明显增加,差异均有统计学意义(P＜0.01);内膜佳组排卵日A型内膜率为24.5％(12/49),较内模差组4.3％(1/23)明显增加,差异有统计学意义(P＜0.05).两组患者黄体中期血E2、P水平比较差异均无统计学意义(P＞0.05).内膜佳组黄体中期子宫内膜腺上皮ER表达及间质PR表达均较内膜差组增强,差异均有统计学意义(P＜0.05).③内膜佳组临床妊娠率及足月分娩率分别为59.1％ (29/49)、55.1％ (27/49),内膜差组分别为13.0％ (3/23)、4.3％(1/23),两组比较差异有统计学意义(P＜0.01).结论:宫腔粘连分离术后黄体中期宫腔镜内膜血管及腺体检查是一种较好的评估子宫内膜功能恢复的方法,对预测妊娠结局有一定的价值.

目的:探讨黏液脓性宫颈炎(mucopurulent cervicitis,MPC)未愈患者行电凝治疗对术后出血及感染的影响.方法:回顾性分析因宫颈柱状上皮异位合并人乳头瘤病毒(HPV)感染自愿接受宫颈电凝治疗的384例患者的临床资料.其中,153例患者电凝治疗前无MPC(无MPC组),121例患者曾有MPC且电凝治疗前MPC已治愈(MPC治愈组),110例患者电凝治疗前MPC漏治(MPC漏治组).比较3组进行宫颈电凝治疗的并发症.结果:①MPC漏治组电凝治疗术中出血、术后出血、术后感染率分别为26.4 ％(29/110)、92.7％(102/110)、71.8％(79/110),较无MPC组的3.3％(5/153)、10.5％(16/153)、11.7％(18/153)及MPC治愈组的4.1％(5/121)、9.1％(11/121)、14.0％(17/121)均明显增加(P＜0.05).而无MPC组及MPC治愈组之间各指标的差异均无统计学意义(P＞0.05).②MPC漏治组电凝治疗术后HPV转阴率、异位柱状上皮鳞化有效率分别为28.1％(31/110)、55.5％(61/110),较无MPC组的73.9％(113/153)、100.0％(153/153)及MPC治愈组的79.3％(96/121)、100.0％(121/121)均明显降低(P＜0.05).结论:MPC漏治容易造成电凝治疗后脱痂期出血及术后感染,降低HPV转阴率及柱状上皮异位痊愈率.

目的:探讨子宫内膜息肉不孕患者增殖期及种植窗期性激素及雌激素受体(ER)和孕激素受体(PR)的改变及意义.方法:选择100例宫腔镜检查见赘生物并经病理证实为子宫内膜息肉(EP)的患者作为EP组,其中,增殖期检查者50例,种植窗期检查者50例.选择60例已生育宫腔镜检查示宫腔正常并经病理证实者作为对照组,其中,增殖期检查者30例,种植窗期检查者30例.采用化学发光法测定患者血清的性激素水平,免疫组织化学方法检测子宫内膜组织中雌激素受体(ER)、孕激素受体(PR)的表达,并进行比较.结果:EP组血清基础雌二醇(E2)水平显著高于对照组(235.59±109.47 pmol/L vs 159.89±87.48 pmol/L,P＜0.05),EP组种植窗期孕酮(P)/E2比值显著低于对照组(0.077 vs 0.090,P＜0.05),其他各项性激素指标及ER各组及各期间比较,差异均无统计学意义(P＞0.05). PR在EP组EP组织种植窗期子宫内膜间质中的表达显著低于EP周围正常内膜与对照组(P＜0.05).结论:对于无月经改变的子宫内膜息肉患者,长期较高水平的E2刺激,PR在分泌期EP间质中处于低水平、相对不足状态可能与息肉形成有关.

Objective:To test the biological properties of polyethylene oviduct contraceptive plug. Methods:Cytotoxicity test,vaginal irritation test,delayed-type hypersensitivity test,implantation test and genotoxicity Ames test were performed for polyethylene oviduct contraceptive plug.Results:Biological tests of polyethylene oviduct contraceptive plug showed that cell relative growth rate in cytotoxicity test was grade 1,and vaginal irritation index was 0,and delayed-type hypersensitivity test was grade 0.There was no abnormal reaction in the implanted location at 3 months after the implantation.Ames test was negative.Conclusion:Biological properties of polyethylene oviduct contraceptive plug meet the registered criteria,and polyethylene oviduct contraceptive plug shows reliable biosecurity.

目的:探讨三维阴道超声(3 D-TVS)诊断后在门诊行宫腔镜下子宫中隔切除术在治疗中隔子宫不孕症患者中的应用价值.方法:选择2008年1月至2011年10月我院经3 D-TVS初步诊断为中膈子宫且未合并盆腔病变的不孕患者71例,其中原发不孕24例,继发不孕47例.全部患者在门诊宫腔镜检查确诊中膈子宫后行子宫中隔切除术及双输卵管插管通液术.术后随访妊娠率及妊娠结局.结果:①经宫腔镜确诊,不完全中隔子宫53例,完全中隔子宫18例.3D-TVS诊断中隔子宫符合率为100.0％ (71/71),明显高于二维经阴道超声(2D-TVS)诊断符合率73.2％ (52/71)和输卵管造影(HSG)诊断符合率59.2％ (42/71),差异有高度统计学意义(P＜0.01).②100％ (71/71)患者1次子宫中隔切除术成功重建宫腔,无手术并发症.术后宫腔镜复查85.9％ (61/71)宫腔形态正常,14.1％( 10/71)宫腔轻度鞍型,输卵管插管术后通畅率达96.5％ (137/142).③原发不孕患者术后妊娠率70.8％ (17/24).继发不孕患者自然流产率由术前84.1％ (58/69)下降为18.6％( 8/43),足月妊娠率由术前2.9％(2/69)上升到74.4％( 32/43),新生儿存活率由术前的5.8％ (4/69)上升到74.4％( 32/43),上述各指标手术前后比较,差异均有高度统计学意义(P＜0.01).结论:3 D-TVS对中隔子宫的准确诊断是门诊无监护宫腔镜术的前提.3D-TVS诊断后在门诊行宫腔镜下子宫中隔切除术安全、可行,患者损伤小,是治疗未合并盆腔病变的中隔子宫不孕症患者的一种有效方法.

Objective:To explore the applicative value of hysteroscopic incision of uterine septum by scissor for uterine septum with infertility after the diagnosis by three-dimensional transvaginal ultrasonography (3D-TVS) in outpatient clinic.Methods:71 cases of uterine septum without pelvic diseases diagnosed by 3D-TVS in Guangdong provincial family planning research institute from January,2008 to October,2011 were divided into two groups:24 cases in primary infertile group,and 47 cases in secondary infertile group.All patients underwent hysteroscopic incision of uterine septum by scissor and tubal catheterization in outpatient clinic,and postoperative pregnancy rate and outcome were followed up.Results:①Through 3D-TVS combined with hysteroscopy,53 cases were diagnosed with incomplete uterine septum,and 18 cases with complete uterine septum.The coincidence rate of 3D-TVS in the diagnosis of uterine septum was 100.0% (71/71),significantly higher than that of transvaginal ultrasonography (73.2%,52/71) and that of hysterosalpingography (59.2%,42/71) (P<0.01).②100.0% (71/71) cases successfully reconstructed uterine cavity without operation complication after one operation.85.9% (61/71) cases showed normal uterine cavity,and 14.1% (10/71) cases showed saddle-shaped uterine cavity.The fallopian patent rate was 96.5%(137/142).③The postoperative pregnancy rate of primary infertile group was 70.8% (17/24).In secondary infertile group,the spontaneous abortion rate was lowered down to 18.6% (8/43),which was 84.1%(58/69) before operation,while the full-term pregnancy rate and live-birth rate were increased to 74.4% (32/43) and 74.4% (32/43) respectively,which were 2.9% (2/69) and 5.8% (4/69) before operation.The above indexes were all significantly different before and after operation.Conclusions:The diagnosis accuracy of 3D-TVS for uterine septum is the premise of hysteroscopic incision of uterine septum without monitoring in outpatient clinic.With combination of 3D-TVS and hysteroscopic incision of uterine septum by scissor is safe,feasible,low-cost and micro-invasive,therefore it is an effective therapeutic method for infertility with uterine septum and without pelvic disease.

目的:探讨不孕妇女子宫内膜息肉中雌激素受体（ER）和孕激素受体（PR）的表达及意义。方法:选择2009年9月至2010年4月在广东省计划生育专科医院就诊伴发子宫内膜息肉的50例不孕妇女（EP组）作为研究组,同期就诊宫腔镜检查正常的29例不孕妇女作为对照组。采用免疫组化方法测定ER和PR在子宫内膜息肉和正常增殖期子宫内膜中的表达,同时采用化学发光法测定所有患者血清的基础性激素（血清卵泡刺激素、黄体生成素、催乳素、雌二醇和睾酮）水平,并对两组的基本情况（年龄、不孕类型、不孕原因、不孕年限及取材时间）进行比较。结果:两组基础性激素水平和基本情况的比较中,仅EP组血清雌二醇水平显著高于对照组（223.39±125.47pmol/Lvs169.96±87.46pmol/L,P=0.046）,其他各项指标的比较,差异均无统计学意义（P＞0.05）。ER和PR在子宫内膜息肉和增殖期子宫内膜中的表达比较,差异均无统计学意义（P=0.085,P=0.527）。结论:对于无月经改变的不孕症子宫内膜息肉,长期较高水平的雌二醇刺激可能与息肉形成有关,但子宫内膜息肉上ER、PR表达未见异常。

目的: 评估新西兰雌兔放置新型输卵管节育栓对其输卵管生殖环境和组织损伤的影响。方法: 将39只雌兔随机分为置栓组(29只, 双侧输卵管放置新型输卵管节育栓)和对照组(10只, 仅行假手术, 不放置输卵管栓)。分别于节育栓植入后第3个月、第6个月、第12个月利用光学显微镜观察输卵管黏膜的组织学改变, 利用免疫组织化学法半定量分析输卵管黏膜血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)及转化生长因子-β1(TGF-β1)的表达。结果: 光学显微镜下, 大部分置栓组输卵管黏膜未见明显炎症细胞浸润, 肌层未见充血和出血, 浆膜层无明显病理异常。对照组和放栓后第3个月、第6个月、第12个月组输卵管黏膜上皮细胞VEGF、TNF-α及TGF-β1表达组间无统计学差异(P>0.05)。结论: 放置新型输卵管节育栓对机体的生殖功能无明显影响, 对兔输卵管组织无明显损伤。

生育调节是生殖健康的核心.随着膨宫技术的进步、冷光源的问世及选择性输卵管插管技术的成熟,宫腔镜直视下输卵管绝育的研究得到很大发展.广东省计划生育科学技术研究所与上海市计划生育科学研究所总结先前经验,根据健康妇女输卵管形态、输卵管黏膜和肌层的扩张度及放置时的可操作性,经过10余年不断实验及反复改进,研制出一种经宫腔镜能准确放置,并与输卵管管壁紧密接触、不随输卵管的蠕动而移位或脱落,取出方便又不损伤输卵管内组织的经宫颈途径可复、高效、微创的输卵管节育栓[1-4].本文将此新型聚乙烯输卵管节育栓避孕可行性的临床探索性研究结果总结如下,为聚乙烯输卵管节育栓下一步开展临床试验提供依据.

Objective To investigate effective way for incomplete patency oviduct.Methods After taken hysterosalpingography(HSG) which results showed oviduct were accessible but not smooth for 163 cases,they were received hytrotubation inducted by the hysteroscope.Results The postoperative patency rate was 85.28% and the postoperative pregnancy rate was 49.69%.Conclusion Hytrotubation inducted by the hysteroscope is passable and effective way to treat accessible but not smooth oviduct.

Objective:To explore the clinical characteristics and pregnancy outcome of hydrosalpinx in infertile women.Methods:A total of 149 infertile women with hydrosalpinx (group A) and 532 infertile women suffering from simple tubal obstruction (group B) were retrospecctively analyzed.Results:The cumulative spontaneous pregnancy rate,intrauterine pregnancy rate,spontaneous abortion rate and ectopic pregnancy rate in group A were 24.8%,86.5%,13.5% and 0%,respectively,and the average duration from treatment until pregnancy was 4.5 ± 4.2 months.While inn group B,those were 24.1%,85.9%,9.4% and 7.0%,respectively,and the average duration from treatment until pregnancy was 4.6 ± 3.7 months.There were no differences of the above indexes between groups A and B (P>0.05).About 91.9% patients suffered from hydrosalpinx ≤3 cm in diameter.Only one patient with hydrosalpinx (>3 cm in diameter) got pregnant.About 90.6% patients suffered from uni-lateral hydrosalpinx.No patient with bilateral hydrosalpinx got pregnant.Conclusion:The infertile women with hydrosalpinx can obtain good pregnancy outcome.The characteristic of hydrosalpinx in infertile women included that most patients' tube diameter ≤ 3 cm and uni-lateral hydrosalpinx.Patients with hydrosalpinx tube diameter >3 cm or bilateral hydrosalpinx could hardly get spontaneous pregnancy.

Objective:To investigate the status of cervicitis and its effect on cervical mucus in azoospermic men's wives.Methods:During June 2010 to October 2010,500 Azoospermic men's wives who were treated in Infertility Clinic of Guangdong Provincial Family Planning Research Institute were recruited and examined for the pathogen and leukocyte from cervical secretions and vaginal discharge.Serum antisperm antibodies(AsAb),herpes simple virus(HSV) and cytomegalovirus(CMV) were examined by ELISA,meanwhile cervical mucus score(CMS)was recorded during periovulatory phase.Kremer,s test and sperm-cervical mucus contact(SCMC) test were checked in women with high AsAb level.Results:According to the diagnostic creteria,500 women were divided into two groups:cervicitis group(n=92,18.4%) and the control group(n=408,81.6%).The positive rates of chlamydia trachomatis(CT),ureaplasma urealyticum(UU),bacterial vaginosis(BV)and HPV in cervical mucus in cervicitis group were significantly higher than those in the control group(P0.01).Serum HSV and CMV positive rates in cervicitis group were also higher than those in control group(P0.05).The cervical mucus score in cervicitis group was significantly higher than that in the control group(9.32±1.91 vs.12.67±2.14,P0.05).There were no significant differences in cervical mucus volume,elasticity and fern crystals between the two group(P0.05),while there were significant differences in cervical mucus viscosity and cell quantity between the two group(P0.01).The positive rate of serum AsAb level in the cervicitis group was significantly higher than that in the control group(33.7% vs.9.8%,P0.01).The abnormal rates of Kremer,s test(10.7% vs.1.2%) and SCMC test(9.8% vs.1.2%) in the cervicitis group were also significantly higher than those in the control group(P0.01).Conclusions:Cervicitis may result in some changes of physiochemical characteristic of cervical mucus and immunological dysfunction of cervix,and induce infertility through several aspects such as the effect on the sperm viability,motility,storage and capacitation.It is important to early diagnose and treat cervicitis in reproductive aged women.

目的研究宫腔镜(hysteroscopy,HS)在宫外孕后继发输卵管性不孕妇女中的应用价值。方法回顾性分析曾经发生过宫外孕后继发输卵管不孕行宫腔镜诊治的125例患者的资料。结果术前术后输卵管的通畅性比较差异有显著性(P<0.01)。输卵管间质部阻塞HS术后通畅率为79.50%,峡部阻塞术后通畅率为82.14%,壶腹部阻塞术后通畅率为37.50%,术中发现宫腔病变22例。结论对宫外孕后继发输卵管性不孕的患者可以根据患者具体情况选择宫腔镜诊治。宫腔镜下插管通液能准确了解输卵管通畅情况,并对输卵管间质部及峡部阻塞患者有较好治疗效果,同时术中能发现宫腔病变并作相关治疗。

目的:探索B超检查子宫内膜厚度对选择子宫输卵管碘油造影(HSG)操作时机的影响。方法:2005年1月～2008年2月行HSG的患者共570例,HSG前进行B超检查子宫内膜厚度,术中注意观察副反应。结果:67例患者有11.8%出现碘化油进入盆底静脉的现象。内膜厚度≥8 mm时发生碘化油进入静脉的几率显著升高(Odds ratio 4.88);内膜厚度≤4 mm时对其发生也有影响。结论:B超检查子宫内膜厚度对HSG操作时机的选择有一定的价值。

Objective To investigate prognostic factors for endometrial polyps recurrence after complete hysteroscopy excision of polyps combined with medical treatment.Methods 168 patients with endometrial polyps after hysterscopic excision were collected and divided into four groups:group A(52 cases) was primary polyps,which was not given any treatment after operation;group B(36 cases) was primary polyps,which was given norethisterone for 3 months after operation;group C(26 cases) was recurrence polyps,which was not given any treatment after operation;group D(54 cases) was recurrence polyps,which was given norethisterone for 3-6 months after operation.Logistic regression analysis was used to assess the factors on recurrence.Results The overall rate of recurrence was 11.3%.There was a significant difference among four groups(P0.05),the recurrence of group B was the lowest and group C was the highest.Polyps number,polyps pathologic type,breast cancer patients with tamoxifen and previous polyps were independently associated with higher recurrence.Post-operative pregnancy and medical treatment were pr otective effcets.Conclusion Pregnancy and drugs have a protective effect on disease recurrence of endometrial polyps

OBJECTIVE:To explore predictive value of endometrial receptivity and pregnancy outcome by hysteroscopy examination at the phase of implantation window in unexplained infertile women. METHODS:From Oct. 2007 to Mar. 2009, 93 unexplained infertile women underwent hysteroscopy examination at 7 approximately 9 days after a spontaneous ovulation in Family Planning Research Institute of Guangdong Province. According to the endometrial glandular openings and vascular shape, 79 cases without pathological endometrial changes were divided into 60 cases in good endometrium group and 19 cases in poor endometrium group. The following clinical parameters were analyzed and compared between two groups, including endometrial configuration, thickness, secretion, the development and number of pinopodes, vascular distribution, and the level of sex hormone, leukemia inhibitory factor (LIF) and glycodelin in the uterine flushing, and pregnancy outcome. RESULTS:(1) There was no statistical difference in the level of serum estrogen and progesterone at the phase of implantation window, which were (518 +/- 176) pmol/L, (40 +/- 20) nmol/L in good group and (513 +/- 244) pmol/L, (37 +/- 19) nmol/L in poor group (P < 0.05). The endometrium thickness at periovulatroy and implantation window days (1.06 +/- 0.10) cm/(1.16 +/- 0.08) cm in good group did not show significant difference with (0.93 +/- 0.12) cm/(1.02 +/- 0.10) cm in poor group (P > 0.05). The proportion of type A, B and C endometrium at periovulatory days were 63% (12/19), 37% (7/19) and 0 (0/19) in good group and 23% (14/60), 77% (46/60) and 0 (0/60) in poor group. When compared with those of type A or B between two groups respectively, it all showed statistical difference (P < 0.05). However, at phase of implantation window, endometrium configurations were all type B at both groups. (2) 90% (17/19) of women in good group and 7% (4/60) of women in poor group showed normal endometrial secretion function, which showed significant differences (P < 0.01). (3) The percentage of fully developed pinopodes and abundant pinopodes [84% (16/19) and 90% (17/19)] in good group were significantly higher than 42% (25/60) and 57% (34/60) in poor group (P < 0.05). (4) The level of CD(34) expression and microvessel density [MVD; (40.1 +/- 1.2) positive unit (PU) and (21.7 +/- 4.0)/high power field (HP)] in good group were significantly higher than (18.1 +/- 1.3) PU and (8.5 +/- 1.3)/HP in poor group (P < 0.01). (5) The level of LIF and glycodelin in uterine flushing [(72 +/- 54) ng/L and (196 +/- 20) microg/L] in good group were significantly higher than (15 +/- 16) ng/L and (116 +/- 26) microg/L in poor group (P < 0.05). (6) The rate of clinical pregnancy, spontaneous abortion and term delivery were 74% (14/19), 0 (0/14) and 100% (14/14) in good group and 23% (14/60), 14% (2/14) and 86% (12/14) in poor group, the rate of clinical pregnancy and term delivery in good group were significantly increased when compared with those in poor group (P < 0.01). CONCLUSIONS:Hysteroscopy examination at the phase of implantation window could reflect the development of glandular openings and vasculature. It is a preferable method to evaluate the endometrial receptivity and predict pregnancy outcome.

目的:探讨阴道分泌物多形核白细胞(PMN)对无症状性盆腔炎性疾病(PID)的诊断价值。方法:对237例可能患有盆腔炎性疾病的原发不孕妇女分别进行阴道分泌物多形核白细胞、细菌性阴道病、性传播疾病病原体和腹腔镜检查。结果:112例(47.2%)阴道分泌物镜检发现白细胞,35例(14.8%)经腹腔镜检查确诊为PID。当患者同时感染STD和PMN时,腹腔镜下诊断出PID的比率最高(OR值8.70)。患者同时感染细菌性阴道病(BV)和PMN时,腹腔镜下诊断出PID的比率最高(OR值4.93)。PMN诊断PID的敏感性、特异性、阳性预测值和阴性预测值分别为85.7%、40.6%、26.8%和96.0%。结论:PMN对于诊断无症状性PID具有较高的敏感性和阴性预测值。

Objective:To explore the therapeutic effect of hysteroscopic endometrial polypectomy in infertile women.Methods: A total of 177 infertile women(study group) with diagnosis of endometrial polyp(EP) underwent hysteroscopic endometrial polypectomy and curettage and the postoperative polyp recurrence was recorded,and their postoperative pregnancies were compared with that of 374 infertile women(control group) with diagnosis of normalcavity in the same period.Results: The pregnancy rate was 25.99%(46/177) in the study group and 29.14%(109/374) in control group,respectively.The mean postoperative pregnancy time was 4.8±3.8 months in study group and 5.0±3.9 months in control group,respectively.There were no differences of the pregnancy rate and the mean postoperative pregnancy time between these two groups(P=0.478,P=0.788).Among 131 infertile women of EP in study group who did not get pregnant,76 women had undergone the repeat hysteroscopy during 1～36 months after the operation: 53 cases with normal cavity,while 23 cases with recurrent EP.Conclusions: Endometrial polyp is a main cause of uterine disease in infertility.The hysteroscopic endometrial polypectomy can not only efficiently remove EP,but also bring the reproductive benefit to the infertile women.

Objective To evaluate the endometrial receptivity in the implantation window of the unexplained infertile women from three aspects such as endometrial morphology,cytokine and secreted protein.Methods 71 women with unexplained infertility and 16 normal women were examined in the implantation window,including vaginal B-typed sonography, hysteroscopy and endometrial biopsy,pinopode by scanning electron microscope,the level of glycodelin in uterine fluid and the serum,leukemia inhibitor factor(LIF) and vascular endothelial growth factor(VEGF) expression in the endometrium.Results The endometrial thickness in ovulation and implantation window of unexplained infertile women [(0.93±0.12) cm,(1.02±0.10) cm]was thinner than that of the normal women[(1.06±0.10) cm,(1.16±0.08) cm](P0.01),and the proportion of A-typed endometrium in ovulation of infertile women(45.07%) was also lower than that in normal women(81.25%)(P0.01).The proportion of‘good'endometrium under hysteroscope in infertile women(18.31%)was significantly lower than that in normal women(81.25%).Compared with the normal women,the endometrium in infertile women demonstrated asynchronous development,and the pinopode coverage was deficient,and the pinopode development was delayed.The level of glycodelin in uterine fluid of infertile women(116.34 ng/mL) was lower than that of normal women(196.23 ng/mL)(P0.05).The expression of LIF and VEGF in infertile women was weaker than that of normal women(P0.05).Conclusion The endometrial receptivity deficiency and embryo-endometrial asynchrony may be one of the major causes of unexplained infertility.