A new mechanism of infertility associated with myoma: decreased production of heparin-binding epidermal growth factor in the endometrium

Abstract

Background: The receptive uterus produces the epidermal growth factor receptor ligand heparin binding-epidermal growth factor (HB-EGF), a membrane-associated protein found in the luminal epithelium at the site adjacent to the blastocyte.Objective: To determine the role of HB-FGF in infertility associated with a myoma.Methods: Twenty primary infertiles having myoma and 20 controls were enrolled in the study to examine HB-EGF in the endometrium of the luteal phase of the menstrual cycle. Endometrial biopsy specimens collected during the luteal phase of the cycle underwent H & E staining for dating. Heparin-binding epidermal growth factor analysis cryostate sections were fixed, rehydrated, and incubated with goat polyclonal antibody against human HB-EGF 10 μg/mL. At the same time the negative control slide was incubated with nonimmune goat IgG, the slides were incubated with rabbit antigoat IgG, and the peroxidase reaction was scored using the following scheme: 0 = nonreaction; 1 = mild; 2 = moderate; and 3 = heavy.Results: There is a statistically significant reduction in the production of HB-EGF in the luteal phase of infertile myomatous than in the control group (P <0.005).Conclusion: A new cause of infertility associated with myoma (ie, decreased production of HB-EGF) is important in human implantation.