Abstract
ObjectiveThe aim of this study was to compare the endometrial expression of milk fat globule-EGF factor 8 (MFG-E8), its receptor integrin αvβ3, and leukemia inhibitory factor (LIF) in patients with endometriosis and infertility and in healthy fertile patients during the window of implantation.MethodsFive patients with peritoneal endometriosis and infertility (case group) and four healthy fertile patients (control group) were recruited. All patients were either diagnosed with or ruled out for endometriosis by laparoscopic surgery; the case group underwent surgery for infertility investigation and the control group for tubal ligation. Endometrial biopsies were performed in all patients during the window of implantation (LH+8 to LH+10), and then the samples were analyzed by immunochemistry for MFG-E8, integrin αvβ3, and LIF.ResultsIn patients with endometriosis and infertility, expression of MFG-E8 was significantly increased in the glandular epithelium when compared to healthy fertile patients (p<0.001). Moreover, LIF expression was lower in patients with endometriosis and infertility (p<0.05). Nevertheless, we found no difference in integrin αvβ3 expression between the groups (p=0.084).ConclusionThis study showed for the first time that MFG-E8 expression is impaired in the endometrium of patients with endometriosis and infertility during the window of implantation. Moreover, LIF is also diminished in the endometrium of these patients as shown before.
Highlights
Endometriosis is one of the most common gynecologic diseases, and its clinical manifestations include dyspareunia, dysmenorrhea, chronic pelvic pain, and infertility (Howard, 2009; ASRM, 2006). It is present in approximately 10% of women in fertile age (Härkki et al, 2010), but among infertile patients, endometriosis prevalence can be as high as 25-50% (Dong et al, 2013)
Five patients with endometriosis and infertility were included in the case group and four healthy fertile patients were enrolled in the control group
Immunohistochemistry confirmed previous findings and revealed that milk fat globule-EGF factor 8 (MFG-E8) was predominantly located in glandular epithelium
Summary
Endometriosis is one of the most common gynecologic diseases, and its clinical manifestations include dyspareunia, dysmenorrhea, chronic pelvic pain, and infertility (Howard, 2009; ASRM, 2006). It is present in approximately 10% of women in fertile age (Härkki et al, 2010), but among infertile patients, endometriosis prevalence can be as high as 25-50% (Dong et al, 2013). Impaired LIF expression has been shown in patients with unexplained infertility, uterine anatomical abnormalities, and endometriosis (Mikolajczyk et al, 2007; Hasegawa et al, 2012; Dimitriadis et al, 2006)
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