Removal of hydrosalpinges increases endometrial leukaemia inhibitory factor (LIF) expression at the time of the implantation window.
BACKGROUND
The presence of hydrosalpinges is associated with lower implantation and pregnancy rates in women undergoing IVF-embryo transfer, while salpingectomy improves these parameters. Although the mechanism by which hydrosalpinges affects fertility is not entirely understood, an adverse effect on endometrial receptivity has been postulated. In this study, we hypothesized that the adverse effects of hydrosalpinges on fertility may be in part mediated by inappropriate endometrial expression of leukaemia inhibitory factor (LIF), a cytokine implicated in implantation.


METHODS
In order to test our hypothesis, we prospectively examined the expression of LIF during the window of implantation in the endometrium of infertile women (n = 10) with hydrosalpinges prior to and following salpingectomy and of fertile controls (n = 10) by Western blotting and immunohistochemistry.


RESULTS
LIF expression was significantly lower in infertile women with hydrosalpinges compared with fertile controls (P < 0.05). Salpingectomy resulted in an increase in LIF expression in eight out of 10 women with hydrosalpinges. LIF levels were increased by 231 +/-49% (mean +/- SEM) following salpingectomy. Immunohistochemical analysis confirmed the Western blot findings. The increased LIF immunoreactivity was predominantly localized to luminal and glandular epithelial cells.


CONCLUSIONS
Our findings suggest that observed benefit from salpingectomy in infertile women with hydrosalpinges may be in part mediated by the up-regulation of endometrial LIF expression.
Seli
Emre
E
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520-8063, USA.
Kayisli
Umit A
UA
Cakmak
Hakan
H
Bukulmez
Orhan
O
Bildirici
Ibrahim
I
Guzeloglu-Kayisli
Ozlem
O
Arici
Aydin
A
D000328:Adult; D015153:Blotting, Western; D010064:Embryo Implantation / Q000502:physiology*; D004717:Endometrium / Q000378:metabolism*; D005184:Fallopian Tube Diseases / Q000601:surgery*; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000503:physiopathology*; D015850:Interleukin-6 / Q000096:biosynthesis*; D053605:Leukemia Inhibitory Factor; D011247:Pregnancy; D011446:Prospective Studies
D015850:Interleukin-6; C507837:LIF protein, human; D053605:Leukemia Inhibitory Factor