Hydrosalpinges adversely affect markers of endometrial receptivity

Abstract

While in-vitro fertilization (IVF) was initially developed in women with tubal factor infertility, recent clinical studies have suggested that the presence of hydrosalpinges lowers implantation and pregnancy rates. We postulated that these hydrosalpinges cause impaired endometrial receptivity. A total of 103 women with hydrosalpinges were prospectively evaluated, and compared with 55 infertile and 44 fertile controls. All women had endometrial biopsies during the window of implantation, analysed by conventional histological criteria, and also stained for three integrin markers of endometrial receptivity (alpha1beta1, alpha4beta1 and alpha vbeta3). Women with hydrosalpinges (cases) expressed significantly less of the alpha vbeta3 integrin compared with controls. There was no difference in expression of alpha1beta1 or alpha4beta1 among groups. A significantly greater number of cases had out of phase histology and missing alpha vbeta3 (type I defects) and absent integrin expression despite normal histological maturation (type II) defects, compared with controls. Of 20 women with impaired endometrial receptivity who were also biopsied after hydrosalpinx surgery, 70% demonstrated increased alpha vbeta3 expression. Seventy-seven percent of type I and 57% of type II defects were corrected postoperatively. Using markers of endometrial receptivity, this study demonstrates that inflammatory hydrosalpinges have an adverse effect on endometrial receptivity, which in some cases may be overcome by surgical treatment of the hydrosalpinx.

Animal models of implantation

“…Although contradictory reports have been made, women with endometriosis have altered b3 expression either in the glandular epithelium or the endometrial vasculature , Lessey & Castelbaum 1998]). Finally, women with hydrosalpinges, an accumulation of fluid within the fallopian tube, showed reduced b3 levels (Meyer et al 1997).…”

Detection of global DNA methylation and paternally imprinted H19 gene methylation in preeclamptic placentas

“…The slides were evaluated under a light microscope (Olympus BX51, Tokyo, Japan), and the staining intensity of the antibody was analyzed by a semiquantitative analysis HSCORE. 22 The HSCORE was calculated using the following equation: HSCORE¼SPi (i+1), where i was the staining intensity (1¼weak, 2¼moderate and 3¼strong), and Pi was the percentage of the positively stained cells for each intensity varying from 0 to 100%. The assessment of staining intensity and HSCORE were evaluated in a doubleblind condition by three independent observers who did not know the disease status of the samples.…”

Relationship between cytokines and the embryotoxicity of hydrosalpingeal fluid

“…The flow of hydrosalpingeal fluid (HSF) into the endometrial cavity may lead to mechanical flushing of the embryos from the uterus (6). Meyer et al (7) have shown that HSF reduced endometrial integrins which may facilitate implantation. These integrins were restored to normal following the excision of the hydrosalpinges.…”