The membranous adhesions could induce implantation failure despite transplantation of high quality of embryo. Clinically, of the patients who have membranous filmy adhesions, endometrial polyps have been found in not infrequently. Thus this study was tried to evaluate the features of endometrial polyps and the effect of endometrial polyps on formation and extents of membranous adhesions in uterine cavity of infertile patients under hysteroscopy. A retrospective study was conducted on 34 infertile patients who were diagnosed as endometrial polyps with membranous adhesions during hysteroscopy from July 2008 to July 2011. Number, size, location and morophologic type of endometrial polyps were investigated. If needed, methylene blue solution was instillated to endometrial cavity to identify membranous adhesions. Then, associations between membranous adhesions with features of endometrial polyps were evaluated. Mean size of endometrial polyp was cm, the bigger of endometrial polyps was, the larger of extents of membranous adhesions. (p<0.05). Endometrial polyps were locate evenly in endometrial cavity as follows: anterior uterine wall, 39.1%; posterior uterine wall, 34.8%; lateral uterine wall, 26.1%; upper: 29.4%, middle: 32.4%, lower segment, 35.3%. Mean number of endometrial polyps was . The pedunculated type was 37.7% and sessile type was 32.4%. There was no statistically significant association of location, number and morphologic type of endometrial polyps with membranous adhesions. In conclusion, hysteroscopy before in vitro fertilization on infertile patients was worthy because of removing of endometrial polyps and membranous adhesions.

The trophectoderm is one of the earliest cell types to differentiate in the forming placenta. It is an important for the initial implantation and placentation during pregnancy. Trophoblast stem cells (TBSCs) develop from the blastocyst and are maintained by signals emanating from the inner cell mass. However, several limitations including rarity and difficulty in isolation of trophoblast stem cells derived from blastocyst still exist. To establish a model for trophoblast differentiation, we isolated TBSCs from human term placenta (38 weeks) and characterized. Cell cycle was analyzed by measuring DNA content by FACS analysis and phenotype of TBSCs was characterized by RT-PCR and FACS analysis. TBSCs have expressed various markers such as self-renewal markers (Nanog, Sox2), three germ layer markers (hNF68, alpha-cardiac actin, hAFP), trophoblast specific markers (CDX-2, CK7, HLA-G), and TERT gene. In FACS analysis, TBSCs isolated from term placenta showed that the majority of cells expressed CD13, CD44, CD90, CD95, CD105, HLA-ABC, cytokeratin 7, and HLA-G. Testing for CD31, CD34, CD45, CD71, vimentin and HLA-DR were negative. TBSCs were shown to decrease the growth rate when cultured in conditioned medium without FGF4/heparin as well as the morphology was changed to a characteristic giant cell with a large cytoplasm and nucleus. In invasion assay, TBSCs isolated from term placenta showed invasion activities in in vivo using nude mice and in vitro Matrigel system. Taken together, these results support that an isolation potential of TBSCs from term placenta as well as a good source for understanding of the infertility mechanism.