title: Does an increased body mass index affect endometrial gene expression patterns in infertile patients? A functional genomics analysis.
abstract: OBJECTIVE
  To analyze the transcriptomic profile of endometrial gene alterations during the window of implantation in infertile obese patients.
  
  
  METHODS
  Multicenter, prospective, case-control study.
  
  
  METHODS
  Three academic medical centers for reproductive medicine.
  
  
  METHODS
  Infertile patients, stratified into body mass index (BMI) categories according to the World Health Organization guidelines, were included in the study.
  
  
  METHODS
  Endometrial samples were obtained from women undergoing standardized estrogen and P replacement cycles after 5 days of vaginal P supplementation.
  
  
  METHODS
  To identify endometrial gene expression alterations that occur during the window of implantation in infertile obese patients as compared with infertile normal-weight controls using a microarray analysis.
  
  
  RESULTS
  XCL1, XCL2, HMHA1, S100A1, KLRC1, COTL1, COL16A1, KRT7, and MFAP5 are significantly dysregulated during the window of implantation in the receptive endometrium of obese patients. COL16A1, COTL1, HMHA1, KRCL1, XCL1, and XCL2 were down-regulated and KRT7, MFAP5, and S100A1 were up-regulated in the endometrium of obese patients. These genes are mainly involved in chemokine, cytokine, and immune system activity and in the structural extracellular matrix and protein-binding molecular functions.
  
  
  CONCLUSIONS
  Obesity is associated with significant endometrial transcriptomic differences as compared with non-obese subjects. Altered endometrial gene expression in obese patients may contribute to the lower implantation rates and increased miscarriage rates seen in obese infertile patients.
  
  
  BACKGROUND
  NCT02205866.
authors.affiliation: Stanford University Clinic for Reproductive Medicine, Sunnyvale, California. Electronic address: yanna.comstock@gmail.com.
authors.forename: Ioanna A
authors.initials: IA
authors.lastname: Comstock
authors.affiliation: Valencia University/Instituto Valenciano de Infertilidad, Valencia, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Diaz-Gimeno
authors.affiliation: Valencia University/Instituto Valenciano de Infertilidad, Valencia, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Cabanillas
authors.affiliation: Valencia University/Instituto Valenciano de Infertilidad, Valencia, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Bellver
authors.affiliation: Valencia University/Instituto Valenciano de Infertilidad, Valencia, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Sebastian-Leon
authors.affiliation: Stanford University Clinic for Reproductive Medicine, Sunnyvale, California.
authors.forename: Meera
authors.initials: M
authors.lastname: Shah
authors.affiliation: Baylor Family Fertility Center, Texas Children's Hospital Pavilion for Women, Houston, Texas.
authors.forename: Amy
authors.initials: A
authors.lastname: Schutt
authors.affiliation: Baylor Family Fertility Center, Texas Children's Hospital Pavilion for Women, Houston, Texas.
authors.forename: Cecilia T
authors.initials: CT
authors.lastname: Valdes
authors.affiliation: Igenomix, Valencia, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Ruiz-Alonso
authors.affiliation: Igenomix, Valencia, Spain.
authors.forename: Diana
authors.initials: D
authors.lastname: Valbuena
authors.affiliation: Stanford University Clinic for Reproductive Medicine, Sunnyvale, California; Valencia University/Instituto Valenciano de Infertilidad, Valencia, Spain; Baylor Family Fertility Center, Texas Children's Hospital Pavilion for Women, Houston, Texas; Igenomix, Valencia, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Simon
authors.affiliation: Stanford University Clinic for Reproductive Medicine, Sunnyvale, California.
authors.forename: Ruth B
authors.initials: RB
authors.lastname: Lathi
mesh_terms: D000022:Abortion, Spontaneous / Q000235:genetics / Q000503:physiopathology; D015992:Body Mass Index; D002140:California; D016022:Case-Control Studies; D010064:Embryo Implantation / Q000235:genetics; D004717:Endometrium / Q000737:chemistry* / Q000503:physiopathology; D005260:Female; D005298:Fertility / Q000235:genetics*; D020869:Gene Expression Profiling; D005786:Gene Expression Regulation; D053263:Gene Regulatory Networks; D005819:Genetic Markers; D020022:Genetic Predisposition to Disease; D023281:Genomics / Q000379:methods; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000235:genetics* / Q000503:physiopathology; D009765:Obesity / Q000150:complications / Q000175:diagnosis / Q000235:genetics* / Q000503:physiopathology; D010641:Phenotype; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain; D013781:Texas; D059467:Transcriptome
chemical_list: D005819:Genetic Markers
keywords: Endometrial gene expression; endometrial receptivity; infertility; metabolic syndrome; obesity