title: Decidual endovascular trophoblast invasion in women with polycystic ovary syndrome: an experimental case-control study.
abstract: BACKGROUND
  Previous experimental and clinical data suggest impaired decidual trophoblast invasion in patients with polycystic ovarian syndrome (PCOS).
  
  
  OBJECTIVE
  The objective of the study was to test the hypothesis that decidual endovascular trophoblast invasion in pregnant patients with PCOS is impaired and to clarify the potential mechanisms involved.
  
  
  METHODS
  This was an experimental case-control study.
  
  
  METHODS
  The study was conducted at the academic Departments of Obstetrics and Gynecology and the Unit of Pathology (Italy).
  
  
  METHODS
  Forty-five pregnant subjects screened from a wide population of women waiting for legal pregnancy termination were included in the final analysis. Specifically, 15 pregnant patients with PCOS were enrolled as cases and another 30 age- and body mass index (BMI)-matched healthy pregnant women without any feature of PCOS were enrolled as the controls.
  
  
  METHODS
  Interventions included the collection of trophoblastic and decidual tissue at the 12th week of gestation.
  
  
  METHODS
  Clinical, ultrasonographic, and biochemical data as well as the histological analysis of decidual endovascular trophoblast invasion.
  
  
  RESULTS
  The rate of implantation site vessels with endovascular trophoblast invasion (ratio between total number of implantation site vessels and total number of vessels with endovascular trophoblast invasion) and the extent of endovascular trophoblast invasion (proportion between immunoreactive areas to cytokeratin 7 and to CD34) were significantly lower in patients with PCOS compared with healthy non-PCOS controls. Endovascular trophoblast invasion data were significantly and indirectly related to the markers of insulin resistance and testosterone concentrations in PCOS patients.
  
  
  CONCLUSIONS
  Pregnant patients with PCOS patients have impaired decidual trophoblast invasion. Further studies are needed to evaluate the exact mechanisms through which insulin resistance and hyperandrogenemia exert this effect.
authors.affiliation: Obstetrics and Gynecology Unit, Department of Obstetrics, Gynecology and Pediatrics, Azienda Ospedaliera Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico, University of Modena and Reggio Emilia, Viale Risorgimento, 42123 Reggio Emilia, Italy. stefanopalomba@tin.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Palomba
authors.forename: Tiziana
authors.initials: T
authors.lastname: Russo
authors.forename: Angela
authors.initials: A
authors.lastname: Falbo
authors.forename: Annalisa
authors.initials: A
authors.lastname: Di Cello
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Amendola
authors.forename: Rosa
authors.initials: R
authors.lastname: Mazza
authors.forename: Achille
authors.initials: A
authors.lastname: Tolino
authors.forename: Fulvio
authors.initials: F
authors.lastname: Zullo
authors.forename: Luigi
authors.initials: L
authors.lastname: Tucci
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: La Sala
mesh_terms: D000032:Abortion, Therapeutic / Q000706:statistics & numerical data; D000328:Adult; D016022:Case-Control Studies; D003656:Decidua / Q000098:blood supply / Q000473:pathology*; D005260:Female; D006801:Humans; D009361:Neoplasm Invasiveness; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D011252:Pregnancy Complications, Neoplastic / Q000453:epidemiology / Q000473:pathology / Q000601:surgery / Q000628:therapy; D014328:Trophoblastic Neoplasms / Q000150:complications / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D014327:Trophoblasts / Q000473:pathology*; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000150:complications / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D055815:Young Adult