Abstract
Purpose
Evaluate the incidence of aberrant endometrial integrin (αvβ3 vitronectin) expression in patients at high risk for implantation defects.
Materials and methods
Retrospective case-control trial of 74 consecutive infertile patients with prior failed IVF cycles despite good embryo quality and/or endometriosis who underwent endometrial biopsy 9–11 days after an LH surge to assess the presence or absence of αvβ3 vitronectin. Patients were separated into two groups for analysis based on the presence (Gr. A) or absence (Gr. B) of integrin expression. A subset of Gr. B patients (86.1%) was treated with a 2 month course of a GnRH agonist prior to IVF (Gr. B1). No Gr. A patients were so treated.
Results
Absent αvβ3 vitronectin expression was noted in 48.6% of patients evaluated. A trend towards more severe endometriosis was noted in Gr. B (57.1 vs 31.5%). Responses to controlled ovarian hyperstimulation and IVF cycle outcomes including ongoing pregnancy rates were similar between Gr. B1 patients untreated Gr. A controls (55.6 vs 63.9%).
Conclusions
A high incidence of absent endometrial αvβ3 vitronectin expression is noted in patients at increased risk for implantation defects. Prolonged GnRH agonist therapy prior to an IVF cycle resulted in outcomes similar to untreated controls with positive expression.
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References
Lessey B, Damjanovich L, Coutifaris C, Castelbaum A, Albelda S, Buck C. Integrin adhesion molecules in the human endometrium. Correlation with the normal and abnormal menstrual cycle. J Clin Invest 1992;90:188–95.
Lessey B, Castelbaum A, Buck C, Lei Y, Yowel C, Sun J. Further characterization of endometrial integrins during menstrual cycle and in pregnancy. Fertil Steril 1994;67:497–506.
Campbell S, Swann H, Seif M, Kimber S, Aplin J. Cell adhesion molecules on the oocyte and preimplantation human embryo. Hum Reprod 1995;10:1571–8.
Lindhard A, Beutin-Ley U, Raun V, Islin H, Hoiid T, Rex S, et al. Biochemical evaluation of endometrial function at the time of implantation. Fertil Steril 2002;78:221–33.
Creus M, Ordi J, Fabregios F, Casainjana R, Carmona F, Cardesa A, et al. The effect of different hormone therapies on integrin expression and pinopode formation in the human endometrium: a controlled study. Hum Reprod 2003;18:683–93.
Lessey B, Castelbaum A, Sawin S, Sun J. Integrins as markers of uterine receptivity in women with primary unexplained infertility. Fertil Steril 1995;63:535–42.
Lessey B, Castelbaum A, Sawin S, Buck C, Schinnar R, Bilker W, et al. Aberrant integrin expression in the endometrium of women with endometriosis. J Clin Endocrinol Metab 1994;79:643–9.
Hii L, Rogers P. Endometrial vascular and glandular expression of integrin αvβ3 in women with and without endometriosis. Hum Reprod 1998;13:1030–5.
Ordi J, Creus M, Casamitjana R, Cardesa A, Vanrell J, Balash J. Endometrial pinopode and αvβ3 integrin expression is not impaired in women with endometriosis. J Assist Reprod Genet 2003;20:465–73.
Thomas K, Thomson A, Wood S, Kingsland C, Vince G, Lewis-Jones J. Endometrial integrin expression in women undergoing in vitro fertilization and the association with subsequent treatment outcome. Fertil Steril 2003;80:502–7.
Wolz-Lopez A, Williams A, Russell J, Schwarz S. Should e-tegrity testing be an integral part of a complete in-vitro fertilization (IVF) work-up? Fertil Steril 2004;82 Suppl 2:S12–3 (Abstr.O-31)
Lessey B. Medical management of endometriosis and infertility. Fertil Steril 2000;73:1089–96.
Tei C, Maruyama T, Kuji N, Miyazaki T, Milkami M, Yoshimura Y. Reduced expression of αvβ3 integrin in the endometrium of unexplained infertility patients with recurrent IVF-ET failures: improvement by danazol treatment. J Assist Reprod Genet 2003;20:13–20.
Sallam H, Garcia-Velasco J, Dias S, Arici A. Long-term pituitary down-regulation before in vitro fertilization (IVF) for women with endometriosis. Cochrane Database Syst Rev 2006;(1), Art no. CD004635. DOI 10.1002/14651858.CD004635.pub2
Surrey E, Silverberg K, Surrey M, Schoolcraft W. Effect of prolonged gonadotropin-releasing hormone agonist therapy or the outcome of in vitro fertilization embryo transfer in patients with endometriosis. Fertil Steril 2002;78:699–704.
Gardner D, Schoolcraft W, Wagley L, Schlenker T, Stevens J, Hesla J. A prospective randomized trial of blastocyst culture and transfer in in vitro fertilization. Hum Reprod 1998;13:3434–40.
Acknowledgements
The authors would like to express their gratitude to the superb nursing and embryology teams of the Colorado Center for Reproductive Medicine without whose assistance this work would not have been possible.
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Capsule
Absent endometrial integrin expression was commonly noted in selected infertility patients who, after prolonged GnRH agonist therapy experienced similar IVF outcomes as integrin positive untreated controls.
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Surrey, E.S., Minjarez, D.A. & Schoolcraft, W.B. The incidence of aberrant endometrial αvβ3 vitronectin expression in a high risk infertility population: could prolonged GnRH agonist therapy play a role?. J Assist Reprod Genet 24, 553–556 (2007). https://doi.org/10.1007/s10815-007-9164-3
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DOI: https://doi.org/10.1007/s10815-007-9164-3