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Endometrial progesterone receptors and markers of uterine receptivity in the window of implantation

Lessey BA et al., 1996

Fertility and sterility, 65(3), 477-483

DOI 10.1016/s0015-0282(96)00306-7 PMID 8774273 Source

Abstract

Objective

To compare the expression of endometrial P receptors (PR) levels with markers of endometrial receptivity during the window of implantation.

Design

Prospective, controlled study to examine endometrial PR and three cycle-specific integrins in endometrial biopsies obtained during the window of implantation.

Setting

An academic teaching hospital.

Patients

One hundred seventy-five endometrial biopsies from regularly cycling women with luteal phase defect (LPD; group 1; n = 80), medically treated LPD (group 2; n = 16), minimal and mild endometriosis with aberrant alpha v beta 3 expression (group 3; n = 21), fertile controls (group 4; n = 26), and infertile controls (group 5; n = 32).

Main outcome measure

Immunohistochemical staining intensity of each antigen using the semi-quantitative grading system (HSCORE), compared using analysis of variance with Scheffe's correction.

Results

Among the five groups studied, nuclear PR expression was significantly elevated in glandular epithelial cells from tissue samples with histologic delay > or = 3 days consistent with luteal phase deficiency (LPD; group 1). Failure of PR down-regulation was associated with aberrant alpha v beta 3 integrin expression. Medical correction of LPD was associated with return of normal endometrial histology, normal integrin expression, and the loss of epithelial PR, similar to controls. The other two cycle-dependent integrin markers, alpha 1 beta 1 and alpha 4 beta 1, were not different between groups. In women with aberrant alpha v beta 3 and "in phase" endometrium, epithelial PR expression was not different from controls.

Conclusions

The establishment of normal endometrial receptivity appears to be tightly associated with the down-regulation of epithelial PR. Histologic delay, consistent with LPD, is associated with a failure of PR down-regulation and the lack of normal markers of endometrial receptivity. Occult uterine receptivity defects (aberrant beta 3 expression in otherwise normal histology) are regulated differently, suggesting alternate mechanisms also exist which influence endometrial receptivity.

Topics

Infertility > Female Factor > Ovulatory DysfunctionReproductive Endocrinology > Luteal Phase > DeficiencyReproductive Endocrinology > Progesterone > PhysiologyDiagnostics > Biomarker Monitoring > Urinary MetabolitesEndometriosis > Pathophysiology > Biomarkers
progesterone receptor expression endometrium, alpha v beta 3 integrin implantation, luteal phase defect progesterone receptors, endometrial receptivity markers, window of implantation biomarkers, progesterone down regulation epithelium, endometriosis aberrant integrin expression, luteal phase deficiency diagnosis, uterine receptivity defects, immunohistochemistry endometrial biopsy, cycle dependent integrins fertility, progesterone receptor failure infertility

Cite this article

Lessey, B. A., Yeh, I., Castelbaum, A. J., Fritz, M. A., Ilesanmi, A. O., Korzeniowski, P., Sun, J., & Chwalisz, K. (1996). Endometrial progesterone receptors and markers of uterine receptivity in the window of implantation. *Fertility and sterility*, *65*(3), 477-483. https://doi.org/10.1016/s0015-0282(96)00306-7

Keywords

Adult, Biomarkers, Embryo Implantation, Endometriosis, Endometrium, Female, Humans, Immunohistochemistry, Infertility, Integrin Alpha1beta1, Integrin Alpha4beta1, Integrins, Luteal Phase, Middle Aged, Prospective Studies, Receptors, Lymphocyte Homing, Progesterone, Reference Values, Uterus

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