The morphological and molecular substrate of impaired endometrial receptivity in infertile patients with external genital endometriosis who enter an assisted reproductive technology program


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Abstract

Objective. To study the morphological and molecular substrate of impaired endometrial receptivity in fertile patients with external genital endometriosis who enter an assisted reproductive technology program. Subject and methods. One hundred andforty-eight infertile patients, including 50 women with grade 1-2 external genital endometriosis (a study group), 44 with endometrioid ovarian cysts (a comparison group), and 54 with tuboperitoneal factor of infertility (control group) were examined. All the patients underwent aspiration pipelle endometrial biopsy on 6-8 days following ovulation. Serial paraffin-embedded sections were used to determine the count of pinopodia and the expression of leukemia inhibitory factor (LIF), H0XA10, glycodelin A, integrin a в 3, and aromatase in the superficial epithelium, glandular epithelium, and endometrial stroma. Results. The patients with external genital endometriosis (the study and comparison groups) versus the control group had significantly lowerpinopodium counts (p<0.05) and a decreased expression of LIF, H0XA10, integrin а в and glycodelin A in the superficial epithelium and a significantly increased expression of aromatase in the superficial epithelium, glands, and endometrial stroma (p<0.05). The highest expression of aromatase was seen in patients with endometrioid ovarian cysts. Conclusion. In the patients with infertility concurrent with external genital endometriosis, the endometrium displays a reduction in the levels of pinopodia, LIF, H0XA10, glycodelin A, and integrin ав 3, and an increase in aromatase. At the same time, the magnitude of these changes correlates with the severity of external genital endometriosis. Thus, changed endometrial receptivity may be one of the leading causes of infertility and lower efficiency of the assisted reproductive technology program in patients with external genital endometriosis.

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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 the Russian Federation

Email: e_kogan@oparina4.ru
MD, Professor, Head of Pathology Department

E. A Kalinina

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation

Email: e_kalinina@oparina4.ru
MD, Head of Assisted Technologies in the Infertility treatment Department

A. V Kolotovkina

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation

Email: alexandrager@mail.ru
postgraduate student of Assisted Technologies in the Infertility treatment Department

N. M Faizullina

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation

Email: n_faizullina@oparina4.ru
PhD, a senior researcher, Pathology Department

L. V Adamyan

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation; Moscow State University of Medicine and Dentistry

Email: l_adamyan@oparina4.ru
Academician of the Russian Academy of Medical Sciences (RAMS), MD, PhD, Professor, Honored Master of Science of the Russian Federation, Head Specialist in Obstetrics and Gynecology of Ministry of Healthcare and Social Development of Russia, Head of the Department of Surgical Gynecology of Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, Head of the Department of Reproductive Medicine and Surgery, Faculty of Postgraduate Education, Moscow State University of Medicine and Dentistry.

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