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The role of the Hoxa10/HOXA10 gene in the etiology of endometriosis and its related infertility: a review

  • Assisted Reproduction Technologies
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Abstract

Purpose

Endometriosis and its associated infertility have been the object of continuous research for over a century. To understand the molecular mechanisms underlying the disease, it has become necessary to determine the aspects of its etiology that are not explained by the retrograde menstruation theory. This could in turn elucidate how various clinical and surgical treatments might affect the evolution and remission of the disease.

Methods

This review is focused on the most recent clinical and laboratory findings regarding the association of HOXA10 with endometriosis and infertility.

Result

The homebox (Hox/HOX) proteins are highly conserved transcription factors that determine segmental body identities in multiple species, including humans. Hoxa10/HOXA10 is directly involved in the embryogenesis of the uterus and embryo implantation via regulation of downstream genes. Cyclical endometrial expression of Hoxa10/HOXA10, with a peak of expression occurring during the window of implantation, is observed in the adult in response to estrogen and progesterone. Women with endometriosis do not demonstrate the expected mid-luteal rise of HOXA10 expression, which might partially explain the infertility observed in many of these patients. Recent studies also demonstrated HOXA10 expression in endometriotic foci outside the Müllerian tract.

Conclusions

Multiple lines of evidence suggest that the actions of the homeobox A10 (Hoxa10/HOXA10) gene could account for some aspects of endometriosis.

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Acknowledgments

We would like to acknowledge Miss Claudia Ricci for providing the illustrations of this article.

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Authors and Affiliations

  1. Huntington Medicina Reprodutiva, Av. República do Líbano, 529—Ibirapuera, 04501-000, São Paulo, SP, Brazil

    Alysson Zanatta, André M. Rocha, Ricardo M. A. Pereira, Eduardo L. A. Motta & Paulo C. Serafini

  2. Departamento de Patologia, Faculdade de Medicina de São Paulo, São Paulo, SP, Brazil

    Filomena M. Carvalho

  3. Departamento de Ginecologia, Hospital das Clínicas, Faculdade de Medicina de São Paulo, São Paulo, SP, Brasil

    Alysson Zanatta, Edmund C. Baracat & Paulo C. Serafini

  4. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT, USA

    Hugh S. Taylor

  5. Departamento de Ginecologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil

    Eduardo L. A. Motta

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  1. Alysson Zanatta
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  2. André M. Rocha
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  4. Ricardo M. A. Pereira
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  5. Hugh S. Taylor
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  6. Eduardo L. A. Motta
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Correspondence to Alysson Zanatta.

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Capsule

The homebox gene Hoxa10/HOXA10 might be related to the embryogenic etiology of endometriosis, as well as to its associated infertility.

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Zanatta, A., Rocha, A.M., Carvalho, F.M. et al. The role of the Hoxa10/HOXA10 gene in the etiology of endometriosis and its related infertility: a review. J Assist Reprod Genet 27, 701–710 (2010). https://doi.org/10.1007/s10815-010-9471-y

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