Abstract
BackgroundUterine receptivity and implantation are complex processes requiring coordinated expression of molecules by zygote and uterus. Our objective was to evaluate the role of the endometrial expression of leukemia inhibitory factor (LIF) and its glycoprotein 130 (gp130) receptor molecules and their secretion in uterine flushing during the window of implantation in cases of primary unexplained infertilityCase presentationThe study was conducted on 25 infertile women with unexplained infertility for at least two years and 10 normal fertile women as a control group . Endometrial tissue and uterine flushing were obtained. Each tissue specimen was divided into two pieces; one piece was used for histological dating of the endometrium and for immunostaining of progesterone receptors, and the second was used for RNA extraction and PCR assay of LIF and gp130 mRNA expression. Serum estrogen and progesterone were measured for all subjects. LIF mRNA was expressed in the endometrium of all normal fertile women but significantly decreased in infertile women. LIF was not detectable in 88% of infertile women while it was fairly detectable in 12% of them. Gp130 mRNA was hardly detectable in both fertile and infertile women with no difference between them. Infertile women secreted significantly less LIF and gp130 molecules in the uterine flushing compared with normal fertile women.ConclusionsExpression of LIF mRNA in endometrium could be used as a molecular marker of unexplained infertility. Assessment of secreted LIF and gp130 molecules in uterine flushing could be another useful and safe method for predicting successful implantation as well as for diagnosing and eventually treating women with impaired fertility using recombinant human LIF.
Highlights
Uterine receptivity and implantation are complex processes requiring coordinated expression of molecules by zygote and uterus
Expression of leukemia inhibitory factor (LIF) Messenger RNA (mRNA) in endometrium could be used as a molecular marker of unexplained infertility
The fact that LIF is the key molecule in the implantation process in monkeys and mice inspired similar research in humans, which demonstrates that LIF mRNA is present in endometrium, and that increased LIF expression coincides with the implantation window
Summary
The implantation process is considered the most relevant limiting factor for successful pregnancy. Several studies have reported lower LIF in uterine flushing samples from women with primary unexplained infertility than in fertile women, and lower LIF secretion from endometrial explants of infertile women than fertile ones, especially during the implantation window [11,19,21]. The biological activity of LIF in the endometrium is affected by the levels of their soluble gp130 receptor They reported that the reduced secretion of gp130 by infertile women during the widow of implantation points to a functional difference in endometrium at that time. The study indicates the possibility that endometrium of women with idiopathic infertility has abnormalities in expression and secretion of important cytokines as LIF and its gp130 receptor molecules, which may contribute to altered uterine receptivity and so infertility.
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