Comparison of Endometrial Receptivity Markers Between Women with Polycystic Ovary Syndrome, Endometrioma and Unexplained Subfertility: A Cross-Sectional Study

Abstract

Objective: Uterine receptivity and implantation are complex processes that require the coordinated expression of molecules by the zygote and uterus. Some molecules have been identified at different stages of the luteal phase as receptivity markers that play roles in implantation. This cross-sectional prospective study aimed to compare the levels of insulin-like growth factor binding protein 1 (IGFBP 1), osteopontin (OPN) and prostaglandin E2 (PGE2) in endometrial flushing liquid during the midluteal phase between patients diagnosed with polycystic ovary syndrome (PCOS), endometrioma and unexplained subfertility, and ovulatory women. Material and Methods: The study groups were formed by women with ovulatory PCOS (n=24), endometrioma (n=17) and unexplained subfertility (n=25). The control group consisted of fertile women (n=18). During the implantation window, endometrial flushing samples were taken and IGFBP1, OPN and PGE2 levels were analyzed and compared among the groups. Results: There were no significant differences in the levels of IGFBP1, PGE2 and OPN among groups. PGE2 levels were 367.7±96.3 ng/mL and 239.2±106.9 ng/mL in women with PCOS and in healthy women, respectively. This difference was statistically significant (p=0.002). The present results show that PGE2 might be an indicator of unfavorable endometrial receptivity and might be responsible for the low pregnancy rates in patients with PCOS. Conclusion: We hypothesized that PGE2 downregulation may facilitate decidualization and improve the pregnancy rate in ovulatory PCOS. So, this can guide us about future treatment in the management of patients.