Salpingectomy increases peri-implantation endometrial HOXA10 expression in women with hydrosalpinx.
OBJECTIVE
To determine whether women with hydrosalpinx would have diminished endometrial HOXA10 expression and whether salpingectomy would reverse HOXA10 suppression. The homeobox gene HOXA10 is a transcription factor that is necessary for embryo implantation; its expression in human endometrium correlates with receptivity and implantation. Increased endometrial HOXA10 expression may be one mechanism by which salpingectomy results in increased implantation rates in IVF.


METHODS
Prospective clinical trial.


METHODS
Academic medical center.


METHODS
Women with unilateral or bilateral hydrosalpinx.


METHODS
Expression of HOXA10 was examined prospectively during the midluteal phase in endometrium obtained from infertile women (n = 9) with hydrosalpinges before and after salpingectomy, as well as from fertile controls (n = 6). Quantitative HOXA10 mRNA expression was determined by real-time reverse-transcription polymerase chain reaction, and HOXA10 protein expression was determined by immunohistochemistry.


METHODS
Expression of HOXA10 mRNA and protein.


RESULTS
Expression of HOXA10 mRNA was significantly lower in infertile women with hydrosalpinges, compared with the case of fertile controls. Salpingectomy resulted in a statistically significant, 15-fold increase in endometrial HOXA10 expression. Immunohistochemical analysis confirmed the quantitative real-time reverse-transcription polymerase chain reaction findings. Increased HOXA10 expression was evident in both glandular epithelial cells and endometrial stroma.


CONCLUSIONS
HOXA10 is necessary for implantation. Here, we demonstrate decreased HOXA10 expression in response to hydrosalpinx fluid as a potential molecular mechanism for diminished implantation rates. Salpingectomy restores endometrial HOXA10 expression. This may be one mechanism by which salpingectomy results in augmented implantation rates in IVF.
Daftary
Gaurang S
GS
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut 06520-8063, USA.
Kayisli
Umit
U
Seli
Emre
E
Bukulmez
Orhan
O
Arici
Aydin
A
Taylor
Hugh S
HS
D000328:Adult; D010064:Embryo Implantation; D004717:Endometrium / Q000378:metabolism*; D005184:Fallopian Tube Diseases / Q000378:metabolism* / Q000601:surgery*; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D000080905:Homeobox A10 Proteins; D018398:Homeodomain Proteins / Q000378:metabolism*; D006801:Humans; D007247:Infertility, Female / Q000378:metabolism* / Q000601:surgery*; D016896:Treatment Outcome
D000080905:Homeobox A10 Proteins; D018398:Homeodomain Proteins; C069634:HOXA10 protein, human