Endometrial receptivity in patients with benign uterine diseases and infertility before and after surgery


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Abstract

Objective. To assess the receptivity of the endometrium in patients with benign uterine diseases and infertility before and after surgery. Materials and methods. During the first stage of the study, 1466 patients with benign uterine diseases and infertility were examined and surgically treated in the Department of Operative Gynecology before starting the IVF program. The patients underwent IVF treatment with controlled ovarian stimulation and transfer of embryos to the uterine cavity, or transfer of previously cryopreserved embryos to the uterine cavity (cryoprotocol). Histological and immunohistochemical (IHC) study of pippele endometrial biopsies was carried out during the implantation window in cycles before surgery and IVF. The endometrial samples were obtained from 60 patients with benign uterine diseases and infertility (adenomyosis, fibroids, intrauterine septum, endometrial polyps, and intrauterine synechiae) and in 10patients with tuboperitoneal infertility without any endometrial or myometrialpathology. Results. IHC study of endometrial biopsies revealed statistically significant differences in the expression of endometrial receptivity markers (estrogen (ER) and progesterone (PR) receptors, leukemia-inhibiting factor (LIF), vascular endothelial growth factor A (VEGF-A), claudin (CLDN-5), matrix metalloproteinases (MMP-2, MMP-9), HOXAW/HOXA11 genes in patients before and after surgical treatment and in patients of the control group. Conclusion. Benign uterine diseases have a negative effect on endometrial receptivity, which is expressed in moderate PR expression, low PR/ER index, moderate LIF expression level, low and moderate integrin expression levels, low VEGF-A expression, moderate MMP2 expression and low MMP9 expression, weak expression of HOXA10 and HOXA11. After surgical treatment, there was a statistically significant improvement in endometrial receptivity: an increase in the expression level of PR and ER receptors, normalized PR/ER index level, an increase in the expression level of LIF, integrin, VEGF-A.

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About the authors

Irena F. Kozachenko

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

Email: i_kozachenko@oparina4.ru
PhD, leading researcher of the Gynecological Department

Nafisa M. Fayzullina

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

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

Aleksandr I. Shchegolev

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

Email: ashegolev@oparina4.ru
MD, Professor, Head of 2st Pathology Department

Leila V. Adamyan

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

Email: aleila@inbox.ru
MD, Professor, Academician of the Russian Academy of Sciences, Head of the Gynecological Department, Deputy of Scientific Director

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