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In This Article

  • Summary
  • Abstract
  • Introduction
  • Protocol
  • Representative Results
  • Discussion
  • Acknowledgements
  • Materials
  • References
  • Reprints and Permissions

Summary

This article describes a detailed protocol for producing a reliable and reproducible thin endometrium with a very low mortality rate and minimal intrauterine adhesions by injecting 95% ethanol into the mouse uterus within 1-3 min.

Abstract

Thin endometrium (TE) has been widely recognized as a critical cause of infertility. However, the pathogenesis of TE remains unclear, and satisfactory treatment options are still urgently needed. Several animal models of TE have been developed, but the mouse model involving abdominal surgery and injection of 95% ethanol presents a formidable challenge due to the high mortality rate and risk of intrauterine adhesions if not performed correctly. Here, we describe a detailed protocol that produces reliable and reproducible TE with a very low mortality rate and minimal intrauterine adhesions by injecting 95% ethanol into the mouse uterus with varying infusion times. The results showed that all of the mice successfully developed TE with infusion times ranging from 1-3 min, characterized by a typical reduction in endometrial thickness and the number of glands, as well as excessive endometrial fibrosis. These findings suggest that this mouse model is suitable for studying thin endometrium and can serve as a platform for developing future TE treatments.

Introduction

Thin endometrium (TE) is a serious condition in obstetrics and gynecology that often affects women of childbearing age. TE is diagnosed when the endometrium thickness measures less than 7 mm on an ultrasound scan, accompanied by a normal uterine cavity, and is closely associated with pregnancy failure1,2. It is estimated that approximately 1.5%-9.1% of women undergoing in vitro fertilization (IVF) treatment will experience TE, making it a growing challenge in reproductive medicine3,4,5. The most common causes....

Protocol

This study was approved by the Institutional Animal Care and Use Committee of Shenzhen Zhongshan Obstetrics & Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital), where all animal experiments were conducted. Female C57BL/6 mice (age 6-8 weeks, weight 18-20 g) were used in this study. All animals were housed in a specific pathogen-free (SPF) environment in the same room and acclimatized for one week before the experiments in a room without specific pathogens at (22 ± 1) °C under a 12-h light/d.......

Representative Results

The key features of thin endometrium (TE) are decreased endometrial thickness and glandular density, along with increased endometrial fibrosis. This method successfully replicated these characteristics in the model mice. Data analysis revealed a significant decrease in endometrial thickness in the 1-min group (222.3 µm ± 13.96 µm vs. 359.2 µm ± 12.41 µm, P < 0.05), the 2-min group (168.7 µm ± 17.57 µm vs. 359.2 µm ± 12.41 µm, P.......

Discussion

TE is characterized by insufficient cell proliferation and dysfunctional cells, closely linked to infertility, recurrent miscarriage, and placental abnormalities2,3. Unfortunately, there is currently no effective therapy for TE. Animal models play a crucial role in studying this condition. Between 2014 and 2024, rats were used as model organisms in 16.4% of 208,000 studies (34,200 studies) and mice in 22.7% (47,300 studies). The increasing use of mice in experime.......

Acknowledgements

We gratefully thank the anonymous referees for their important and helpful comments. This work was supported by the Shenzhen Science and Technology Project (No. JCYJ20220818103207016) and the Guangdong Basic and Applied Basic Research Foundation (No. 2024A1515010478).

....

Materials

NameCompanyCatalog NumberComments
Anesthesia MachineRWD Life ScienceR530Mobile inhalation anesthesia machine for small animals
0.9% salineHubei Kelun Pharmaceutical C230817A210 mL, medical injection
75% ethanolLIRCON6303060031500 mL, disinfectant reagent
95% ethanolGuangzhou Chemical Reagent Factory64-17-5500 mL, chemical reagent
Absorbable suturesJinhuan MedicalCR537Thickness: 5-0; Length: 90 cm
Aqueous ammoniaMilliporeSigma1336-21-61000 mL, chemical reagent
Automatic Tissue ProcessorLeicaTP1020100 embedding boxes can be processed at one time
C57BL/6 mice Experimental Animal Center of Southern Medical University 
Eosin-YBASOBA40241000 mL, used for the staining of paraffin sections, frozen sections, etc
HaematoxylinBASOBA40411000 mL, used for the staining of paraffin sections, frozen sections, etc
HALO Image Analysis PlatformIndica labsThe instrument features ease-of-use and scalability, powerful analytical capabilities, and the fastest processing speed
Hemostatic clampsHUAYON18-50211.8 cm in total length with 0.7 cm jaw
Hemostatic forcepsHUAYON18-502010 cm in total length
HistoCore Rotary MicrotomeLeica149BIO000C1Slice thickness ranges from 1 to 60 μm
IndorphorADF1005500 mL, disinfectant reagent
IsofluraneRWD Life ScienceR510-22-10100 mL, active ingredient 100% isoflurane
Masson's trichrome stainingSOLARBIOG13407 × 100 mL for 100 tests
Microscope slideGene TechGT100511Length: 75 cm; Width: 25 cm
Modular Tissue Embedding CenterLeicaEG1150 CThe instrument contains a cold stage and a heated paraffin distribution module, providing flexibility for the embedding work
Natural resinSAKURA4770Resin-coated film, Suitable for histology staining
Olympus SLIDEVIEW VS200PANOVUEVS200The instrument captures high-quality virtual slide images and enables advanced quantitative image analysis 
Paraformaldehyde fix solutionServicebioG1011500 mL, universal tissue fixative (neutral)
Surgical forcepsHUAYON18-13002.2 mm straight, 12.5 cm wide
Surgical scissorsHUAYON18-011010 cm, stainless steel surgical scissors
SyringeKindly600170311 mL, disposable sterile syringe with needle
Tissue cassettesCITOTEST80106-1100-16White; flow-through slots; 0ne-piece integral lid; labeling areas are located on three sides
Tissue-Tek Prisma PlusSAKURADRS-Prisma-P-JCSThe processing capacity is 60 slides at one time
XyleneGuangdong Guanghua Sci-Tech1330-20-71000 mL, organic solvent

References

  1. Mahajan, N., Sharma, S. The endometrium in assisted reproductive technology: How thin is thin. J Hum Reprod Sci. 9 (1), 3-8 (2016).
  2. Liu, X., et al.

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