Receptivity of thin endometrium in patients undergoing assisted reproduction


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Abstract

Aim. To investigate the receptivity of the thin endometrium in patients with infertility conceiving and not conceiving in assisted reproductive technology (ART) programs. Materials and methods. This prospective study comprised 32 patients who sought ART treatment for infertility. Patients were stratified into groups by whether they had conceived or fail to conceive, and depending on the endometrial thickness. An endometrial thickness threshold was 8 mm. During the implantation window in the cycle preceding the cycle of ovarian stimulation and embryo transfer, all patients underwent a pelvic ultrasound examination to measure the endometrial thickness and pipelle endometrial biopsy. We studied the expression of estrogen receptors a (ER), progesterone receptors (PR), and leukemia inhibitory factor (LIF) in the endometrial superficial and glandular epithelium, and endometrial stroma. Results. Patients with normal endometrial thickness had an increased ER and decreased PR expressions in all endometrial tissues resulting in a lower PR/ER ratio in the endometrial glands and stroma. The expression of receptivity markers was not statistically significantly associated with the endometrial thickness and the likelihood of pregnancy. Conclusion. There is no significant difference between normal and thin endometrium in the expression of ER, PR, and LIF in the endometrial superficial and glandular epithelium, and endometrial stroma.

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About the authors

G. V Kulikova

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: g_kuNkova@oparina4.ru
PhD., Senior Research Associate, Pathology Department 4 Oparin str, 117997, Moscow, Russia

N. F Abdurakhmanova

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: abd.nigora@yandex.ru
post-graduate student of the 3rd year of the Department of Auxiliary Technologies in Infertility Treatment 4 Oparin str, 117997, Moscow, Russia

N. M Faizullina

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: naflsa05@inbox.ru
PhD., Senior Research Associate, Pathology Department 4 Oparin str, 117997, Moscow, Russia

A. V Asaturova

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: A_asaturova@oparina4.ru
M.D., Ph.D. senior scientific researcher 4 Oparin str, 117997, Moscow, Russia

A. I Shchegolev

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: ashegolev@oparina4.ru
MD, professor, head of Pathology Department 4 Oparin str, 117997, Moscow, Russia

M. M Ziganshina

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: mmz@mail.ru
PhD., Senior Research Associate, Laboratory of Clinical Immunology 4 Oparin str, 117997, Moscow, Russia

N. V Dolgushina

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: n_dolgushina@oparina4.ru
M.D., Ph.D., M.P.H., Head of R&D Department 4 Oparin str, 117997, Moscow, Russia

References

  1. Kumbak B., Erden H.F., Tosun S., Akbas H, Ulug U., Bahgeci M. Outcome of assisted reproduction treatment in patients with endometrial thickness less than 7 mm. Reprod Biomed Online. 2009; 18(1): 79-84. doi: 10.1016/s1472-6483(10)60428-2
  2. Zhang T., Li Z., Ren X., Huang B., Zhu G., Yang W., Jin L. Endometrial thickness as a predictor of the reproductive outcomes in fresh and frozen embryo transfer cycles: A retrospective cohort study of 1512 IVF cycles with morphologically good-quality blastocyst. Medicine (Baltimore). 2018; 97(4): e9689. doi:10.1097/ MD.0000000000009689.
  3. Liu K.E., Hartman M., Hartman A., Luo Z.-C., Mahutte N. The impact of a thin endometrial lining on fresh and frozen-thaw IVF outcomes: an analysis of over 40 000 embryo transfers. Hum Reprod. 2018; 33(10): 1883-8. doi:10.1093/ humrep/dey281.
  4. Gonen Y., Casper R.F., Jacobson W., Blankier J. Endometrial thickness and growth during ovarian stimulation: a possible predictor of implantation in in vitro fertilization. Fertil Steril. 1989; 52(3): 446-50. 4 doi: 10.1016/s0015-0282(16)60916-0
  5. Oliveira J.B., Baruffi R.L., Mauri A.L., Petersen C.G., Borges M.C., Franco J.G. Endometrial ultrasonography as a predictor of pregnancy in an in-vitro fertilization programme after ovarian stimulation and gonadotrophin-releasing hormone and gonadotrophins. Hum Reprod. 1997; 12(11): 2515-8. doi: 10.1093/humrep/12.11.2515
  6. Khalifa E., Brzyski R.G., Oehninger S., Acosta A.A., Muasher S.J. Sonographic appearance of the endometrium: the predictive value for the outcome of in-vitro fertilization in stimulated cycles. Hum Reprod. 1992; 7(5): 677-80. doi: 10.1093/oxfordjournals.humrep.a137718
  7. Serafini P., Batzofin J., Nelson J., Olive D. Sonographic uterine predictors of pregnancy in women undergoing ovulation induction for assisted reproductive treatments. Fertil Steril. 1994; 62(4): 815-22. doi: 10.1016/s0015-0282(16)57010-1
  8. Weiss N.S., van Vliet M.N., Limpens J., Hompes P.G.A, Lambalk C.B., Mochtar M.H., van der Veen F., Mol B.W.J, van Wely M. Endometrial thickness in women undergoing IUI with ovarian stimulation. How thick is too thin? A systematic review and meta-analysis. Hum Reprod. 2017;32(5): 1009-18. doi: 10.1093/humrep/dex035.
  9. Sher G., Herbert C., Maassarani G., Jacobs M.H. Assessment of the late proliferative phase endometrium by ultrasonography in patients undergoing in-vitro fertilization and embryo transfer (IVF/ET). Hum Reprod. 1991; 6(2): 232-7. doi: 10.1093/oxfordjournals.humrep.a137312
  10. Check J.H., Lurie D, Dietterich C., Call an C., Baker A. Adverse effect of a homogeneous hyperechogenic endometrial sonographic pattern, despite adequate endometrial thickness on pregnancy rates following in-vitro fertilization. Hum Reprod. 1993; 8(8): 1293-6. doi: 10.1016/j.fertnstert. 2009.12.025
  11. Абдурахманова Н.Ф., Гвоздева А.Д., Зиганшина М.М., Долгушина Н.В. Результаты программ ВРТ у пациенток с «тонким» эндометрием. Гинекология. 2019; 21(1): 23-27.
  12. Приказ Минздрава России №107н от 30 августа 2012 г «О порядке использования вспомогательных репродуктивных технологий, противопоказаниях и ограничениях к их применению». 2012
  13. Gardner D.K., Schoolcraft W.B. Culture and transfer of human blastocysts. Curr Opin Obstet Gynecol. 1999; 11(3): 307-11. PMID: 10369209
  14. Noyes N, Liu H.C., Sultan K., Schattman G., Rosenwaks Z. Endometrial thickness appears to be a significant factor in embryo implantation in in-vitro fertilization. Hum Reprod. 1995; 10(4): 919-22. doi: 10.1093/oxfordjournals. humrep.a136061
  15. Rinaldi L., Lisi F., Floccari A., Lisi R., Pepe G., Fishel S. Endometrial thickness as a predictor of pregnancy after in-vitro fertilization but not after intracytoplasmic sperm injection. Hum Reprod. 1996; 11(7): 1538-41. doi: 10.1093/oxfordjournals.humrep.a019434
  16. Weissman A., Gotlieb L., Casper R.F. The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in an in vitro fertilization program. Fertil Steril. 1999; 71(1): 147-9.
  17. Bassil S. Changes in endometrial thickness, width, length and pattern in predicting pregnancy outcome during ovarian stimulation in in vitro fertilization. Ultrasound Obstet Gynecol. 2001; 18(3): 258. doi: 10.1046/ j.1469-0705.2001.00502.x.
  18. Kovacs P, Matyas S., Boda K., Kaali S.G. The effect of endometrial thickness on IVF/ICSI outcome. Hum Reprod. 2003; 18(11): 2337-41. DOI: 10.1093/ humrep/deg461
  19. Dain L., Bider D., Levron J., Zinchenko V., Westler S., Dirnfeld M. Thin endometrium in donor oocyte recipients: enigma or obstacle for implantation? Fertil Steril. 2013; 100(5): 1289-1295.e2. doi: 10.1016/j.fertnstert.2013.07.1966.
  20. Miwa I., Tamura H., Takasaki A., Yamagata Y., Shimamura K., Sugino N. Pathophysiologic features of «thin» endometrium. Fertil Steril. 2009;91(4):998- 1004. doi: 10.1016/j.fertnstert.2008.01.029.
  21. Takasaki A., Tamura H., Taketani T., Shimamura K., Morioka H., Sugino N. A pilot study to prevent a thin endometrium in patients undergoing clomiphene citrate treatment. J Ovarian Res. BioMed Central; 2013; 6(1): 94. doi: 10.1186/1757-2215-6-94.
  22. Левиашвили М.М., Демура Т.А., Мишиева Н.Г., Файзуллина Н.М., Назаренко Т.А., Калинина Е.А. Оценка рецептивности эндометрия у пациенток с безуспешными программами экстракорпорального оплодотворения в анамнезе. Акушерство и гинекология. 2012; 4 (1): 65-9.
  23. Коган Е.А., Калинина Е.А., Колотовкина А.В., Файзуллина Н.М., Адамян Л.В. Морфологический и молекулярный субстрат нарушения рецептивности эндометрия у бесплодных пациенток с наружным генитальным эндометриозом. Акушерство и гинекология. 2014; (8): 47-51
  24. Moberg C. Levels of oestrogen receptor, progesterone receptor and aB-crystallin in eutopic endometrium in relation to pregnancy in women with endometriosis. Hum Fertil. 2014; (19): 1-8. doi: 10.3109/ 14647273.2014.922705.
  25. Денисова В.М., Ярмолинская М.И., Полякова В.О., Рулев В.В., Дурнова А.О. Особенности экспрессии рецепторов половых стероидных гормонов при наружном генитальном эндометриозе. Молекулярная медицина.
  26. Leach R.E., Jessmon P., Coutifaris C., Kruger M., Myers E.R., Ali-Fehmi R., Carson S.A., Legro R.S., Schlaff W.D., Carr B.R., Steinkampf M.P., Silva S., Leppert P.C., Giudice L., Diamond M.P. High throughput, cell type-specific analysis of key proteins in human endometrial biopsies of women from fertile and infertile couples. Hum Reprod. 2012; 27(3): 814-28. doi: 10.1093/humrep/ der436.
  27. Bulun S.E., Cheng Y.H., Pavone M.E., Xue Q., Attar E., Trukhacheva E., Tokunaga H., Utsunomiya H., Yin P., Luo X., Lin Z., Imir G., Thung S., Su E.J., Kim J.J. Estrogen receptor-beta, estrogen receptor-alpha, and progesterone resistance in endometriosis. Semin Reprod Med. 2010; 28(1): 36-43. doi: 10.1055/s-0029-1242991.
  28. Dimitriadis E., Menkhorst E., Salamonsen L.A., Paiva P. Review: LIF and IL11 in trophoblast-endometrial interactions during the establishment of pregnancy. Placenta. 2010; 31 Suppl: S99-104. doi: 10.1016/j.placenta. 2009.12.027.
  29. Marwood M., Visser K., Salamonsen L.A., Dimitriadis E. Interleukin-11 and leukemia inhibitory factor regulate the adhesion of endometrial epithelial cells: implications in fertility regulation. Endocrinology. 2009; 150(6): 2915-23. doi: 10.1210/en.2008-1538.
  30. Dimitriadis E., Sharkey A.M., Tan Y.L., Salamonsen L.A., Sherwin J.R.A. Immunolocalisation of phosphorylated STAT3, interleukin 11 and leukaemia inhibitory factor in endometrium of women with unexplained infertility during the implantation window. Reprod Biol Endocrinol. 2007; 5: 44. doi: 10.1186/1477-7827-5-44.
  31. Dimitriadis E., Stoikos C., Stafford-Bell M, Clark I., Paiva P., Kovacs G., Salamonsen L.A. Interleukin-11, IL-11 receptoralpha and leukemia inhibitory factor are dysregulated in endometrium of infertile women with endometriosis during the implantation window. J Reprod Immunol. 2006; 69(1): 53-64. doi: 10.1016/j.jri.2005.07.004.
  32. Tsai H.D., Chang C.C., Hseih Y.Y., Lo HY. LIF expression in different endometrial locations between fertile and infertile women throughout different menstrual phases. JARG. 2000; 17(8): 415-8. DOI: 10.1023/ a:1009457016871
  33. Ниаури Д.А., Гзгзян А.М., Кветной И.М., Коган И.Ю., Джемлиханова Л.Х., Крихели И.О., Федорова И.Д., Лесик Е.А., Шарфи Ю.Н., Крылова Ю.С., Шильникова Е.М. Иммуногистохимическая характеристика рецептивности эндометрия в циклах ЭКО. Акушерство и гинекология. 2014; (9): 44-9.

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