Salpingectomy increases peri-implantation endometrial HOXA10 expression in women with hydrosalpinx.
ABSTRACT To determine whether women with hydrosalpinx would have diminished endometrial HOXA10 expression and whether salpingectomy would reverse HOXA10 suppression. The homeobox gene HOXA10 is a transcription factor that is necessary for embryo implantation; its expression in human endometrium correlates with receptivity and implantation. Increased endometrial HOXA10 expression may be one mechanism by which salpingectomy results in increased implantation rates in IVF.
Prospective clinical trial.
Academic medical center.
Women with unilateral or bilateral hydrosalpinx.
Expression of HOXA10 was examined prospectively during the midluteal phase in endometrium obtained from infertile women (n = 9) with hydrosalpinges before and after salpingectomy, as well as from fertile controls (n = 6). Quantitative HOXA10 mRNA expression was determined by real-time reverse-transcription polymerase chain reaction, and HOXA10 protein expression was determined by immunohistochemistry.
Expression of HOXA10 mRNA and protein.
Expression of HOXA10 mRNA was significantly lower in infertile women with hydrosalpinges, compared with the case of fertile controls. Salpingectomy resulted in a statistically significant, 15-fold increase in endometrial HOXA10 expression. Immunohistochemical analysis confirmed the quantitative real-time reverse-transcription polymerase chain reaction findings. Increased HOXA10 expression was evident in both glandular epithelial cells and endometrial stroma.
HOXA10 is necessary for implantation. Here, we demonstrate decreased HOXA10 expression in response to hydrosalpinx fluid as a potential molecular mechanism for diminished implantation rates. Salpingectomy restores endometrial HOXA10 expression. This may be one mechanism by which salpingectomy results in augmented implantation rates in IVF.
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ABSTRACT: Background: Endometrial integrin expression changes might be a reason for implantation failure in polycystic ovarian syndromes (PCOS). Objective : Assessment of integrin genes and proteins expression upon endometrium in the PCOS experimental mouse model was the main goal of this study. Materials and Methods: 30 NMRI female mice were equally divided into control, experimental (PCOS; received estradiol valerate (40 mg/kg)) and sham group (received; olive oil). After 8 weeks, each group was hyper stimulated by 7 IU PMSG and then, after 48hrs, 7 IU HCG was injected. Vaginal plaque was checked. After 5 days, Progesterone and estradiol levels and endometrial tissues were investigated to evaluate of α4, αv, β1 and β3 integrins gene and protein by qPCR method and immunohistochemistry, respectively. Results: Tissue samples were assessed and showed that level of progesterone was significantly decreased in PCOS group. Results of molecular part in the amount of αv, β3, β1 and α4 gene expressions showed a great difference in β3 and αv genes expressions between experimental groups. αv, β3, α4 and β1 proteins in the endometrial stroma in the control group were expressed, but they were not detected in PCOS group. Conclusion: According to the results, integrins had different expression patterns in different areas of the endometrium; such as epithelial and stromal. It seems that in PCOS, this pattern has changed and the results might have a great influence on implantation failure. Therefore, this study suggests that a great attention to this problem may be essential in patients who are involved.Iranian Journal of Reproductive Medicine 10/2014; 12(10):687-694. · 0.19 Impact Factor
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ABSTRACT: Surgery is a main management strategy in treatment of infertility originating from uterine, ovarian or tubal pathologies. However, benefits of surgery in accordance with the type of pathologies could not always be predicted. In summary, this review revealed that surgical correction of some pathologies lead to a significant improvement in fertility, such as submucous myomas or intramural myomas distorting endometrial cavity; however, benefit of surgery is controversial in some specific conditions including endometriomas. Outcome of surgical correction mostly depends on the type of pathology in uterine anomalies. Surgical treatment is a well-established approach in management of hydrosalpinx and it should be recommended before assisted reproduction. Reproductive surgery should be individualized according to the patient characteristics including age, duration of infertility, previous pregnancy losses and type of associated pathology.Expert Review of Obstetrics & Gynecology 01/2014; 8(5).
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ABSTRACT: We report the hysteroscopic findings in a 22 year old nulligravid patient with bilateral communicating hydrosalpinges. The inflamed hyperemic endometrial cavity encountered preoperatively normalized at second look hysteroscopy six months after bilateral tubal interruption. The patient underwent successful IVF with culmination in a singleton, live birth. We propose that an inflamed appearance at hysteroscopy, done for endometrial cavity screening, should prompt a dedicated study to rule out hydrosalpinx prior to proceeding with IVF treatment. To date, such a hysteroscopic endometrial phenotype in the presence of hydrosalpinx has not been well characterized.Journal of surgical case reports. 01/2012; 2012(1):8.