ENDOMETRIAL MORPHOLOGICAL AND MOLECULAR BIOLOGICAL FEATURES DURING THE IMPLANTATION WINDOW IN PATIENTS WITH INFERTILITY CONCURRENT WITH STAGES 1-2 EXTERNAL GENITAL ENDOMETRIOSIS


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Abstract

Objective. To study endometrial morphological and molecular biological features in patients with infertility and Stage 1—2 external genital endometriosis (EGE) during the implantation window. Subject and methods. Seventy-two infertile patients, including 23 with Stage 1-2 EGE and 32 with tuboperitoneal factor (TPF) infertility, and 17 with male factor (MF) infertility were examined. All the patients underwent pipelle (aspiration) endometrial biopsy at 6-8 weeks after ovulation, followed by histological and immunohistochemical examinations. The number of pinopodia, the expression of estrogen receptor-α (ER-α) and progesterone receptor A (PR-A) in the endometrial stroma and epithelium, as well as stromal PR/ER-а ratio were determined. Results and discussion. The patents with Stage 1-2 EGE were found to have a significant increase in the expression of ER-α in both the endometrial stroma and epithelium (p=0.031 and p=0.027). In all the groups, the endometrial stromal and epithelial level of PR-A was decreased in relation to the phase of endometrial development (p = 0.013; p = 0.032); but was statistically indifferent between the groups (p=0.186; p=0.503). The mean number of pinopodia in the endometrium of the patients with Stage 1-2 EGE and TPF was significantly lower than in those with MF (p = 0.02). Conclusion. The findings suggest that in patients with infertility concurrent with Stage 1-2 EGE, impaired endometrial receptivity occurs during the implantation window which manifests itself as lower pinopodium count and impaired hormone receptor balance. The significantly higher epithelial and stromal ER-α levels are the peculiarity of endometrial changes during the implantation window in Stage 1-2 EGE. This, in turn, may be one of the leading causes of infertility and the lower efficiency of an LVF program in patients with this disease.

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About the authors

E. A KOGAN

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: e_kogan@oparina4.ru

A. V KOLOTOVKINA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: alexandrager@mail.ru

N. M FAIZULLINA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: n_faizullina@oparina4.ru

E. A KALININA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: e_kalinina@oparina4.ru

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