Laparoscopic endometrioma resection increases peri implantation endometrial HOXA 10 and HOXA 11 mRNA expression

Capsule:
There is a receptivity defect within the endometrium of women with endometrioma that affects fertility. Laparoscopic endometrioma resection enhances endometrial HOXA-10 and HOXA-11mRNA expression, suggesting an improvement in endometrial receptivity.

Authors:
Onder Celik, M.D., Cihat Unlu, M.D., Baris Otlu, Ph.D., Nilufer Celik, M.D., Eray Caliskan, M.D.

Volume 104, Issue 2, Pages 356-365

Abstract:

Objective:
To determine whether laparoscopic endometrioma resection alters peri-implantation endometrial HOXA-10, HOXA-11, LIF, ITGB3 and ITGAV mRNA expression.

Design:
Case-control study.

Setting:
Medical school.

Patient(s):
Twenty infertile patients with uni- or bilateral endometrioma, five infertile patients having nonendometriotic benign ovarian cyst, and five fertile control subjects.

Intervention(s):
Mid–luteal-phase endometrial sampling was performed at the time of surgery. Second endometrial biopsies were obtained 3 months after laparoscopic endometrioma resection during the mid-luteal phase of the cycle.

Main Outcome Measure(s):
Endometrial HOXA-10, HOXA-11, LIF, ITGAV, and ITGB3 mRNA expressions were evaluated with the use of reverse-transcription polymerase chain reaction.

Result(s):
Significantly decreased endometrial ITGAV mRNA expression was noted in biopsies obtained from endometrioma and nonendometriotic cyst groups before surgery. Trends toward decreased endometrial HOXA-10, HOXA-11, LIF, and ITGB3 mRNA expressions were noted in the endometrioma and nonendometriotic cyst groups before surgery compared with the fertile subjects. However, the differences failed to show statistical significance. Compared with preoperative values, significantly increased HOXA-10 (12.1-fold change) and HOXA-11 (17.2-fold change) mRNA expressions were noted in endometrial biopsies obtained from subjects who were undergoing endometrioma surgery. Fold change in endometrial ITGAV mRNA after endometrioma surgery was found to be 30.1 and indicated a positive regulation. However, this fold increase was statistically insignificant. Expressions of these endometrial receptivity markers did not change significantly after surgical removal of nonendometriotic benign ovarian cysts.

Conclusion(s):
Laparoscopic endometrioma resection increases peri-implantation endometrial HOXA-10 and HOXA-11 mRNA expression, suggesting an improvement in endometrial receptivity.

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