Hum. Reprod. Advance Access originally published online on July 15, 2005
Human Reproduction 2005 20(11):3012-3017; doi:10.1093/humrep/dei188
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Removal of hydrosalpinges increases endometrial leukaemia inhibitory factor (LIF) expression at the time of the implantation window
1 Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520–8063, USA, 2 Department of Histology and Embryology, Akdeniz University School of Medicine, Antalya, Turkey, 3 Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA, 4 Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara and 5 Department of Genetics, Akdeniz University School of Medicine, Antalya, Turkey
6 To whom correspondence should be addressed. E-mail: aydin.arici{at}yale.edu
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 6 49% (mean 6 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.
Key words: endometrial receptivity/hydrosalpinx/implantation/leukaemia inhibitory factor/salpingectomy
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