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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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