Hum. Reprod. Advance Access originally published online on October 3, 2008
Human Reproduction 2009 24(1):198-205; doi:10.1093/humrep/den360
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Identification of new biomarkers of human endometrial receptivity in the natural cycle
1 CHU Montpellier, Institut de Recherche en Biothérapie, Hôpital Saint-Eloi, Montpellier F-34000, France 2 CHU Montpellier, Département de Médecine et Biologie de la Reproduction, Hôpital Arnaud de Villeneuve, Montpellier F-34295, France 3 INSERM, U847 ‘Développement embryonnaire précoce et cellules souches embryonnaires humaines’, Montpellier F-34000, France 4 Centre de FIV, Clinique les Jardins, Tunis, Tunisia 5 Merck-Serono, Genève, Switzerland 6 Département de Médecine de la Reproduction, hôpital Jean de Flandre, Lille, France
7 Correspondence address. ART/PGD Division, Département de Médecine et Biologie de la Reproduction, Hôpital Arnaud de Villeneuve, 34295 Montpellier, France. Tel: +33-4-67-33-64-04; Fax: +33-4-67-33-62-90; E-mail: s-hamamah{at}chu-montpellier.fr
BACKGROUND: Identification of new markers assessing endometrial receptivity may help in improving the clinical outcome of IVF. This study aimed at identifying genes expressed in human endometrium during the implantation window that could be used as such markers.
METHODS: A series of normoresponder patients (n = 31) underwent endometrial biopsies (n = 62, 2 per patient) during the early secretory phase, 2 days after the LH surge (LH + 2) and the mid-secretory phase (LH + 7) of the same natural cycle that preceded a new ICSI attempt for male infertility factor. Samples were analyzed using DNA microarrays and gene expression profiles at the time of the implantation window were computed. Systems biology analysis allowed the identification of biological pathways that were over-represented in this signature. A new approach for class prediction applied to microarray experiments was then used to identify biomarkers putatively involved in endometrial receptiveness.
RESULTS: Five genes expressed during the implantation window were all up-regulated in the LH + 7 samples compared with LH + 2 [laminin β3 (P = 0.002), microfibril-associated protein 5 (P = 0.009), angiopoietin-like 1 (P = 0.005), endocrine gland-derived vascular endothelial growth factor (P = 0.049) and nuclear localized factor 2 (P = 0.007)]. Increased expression was validated by quantitative RT–PCR.
CONCLUSIONS: Five genes have been identified for the first time as being up-regulated during the implantation window and are proposed as new biomarkers for exploration of endometrial receptiveness. As the endometrial biopsy procedure can be performed during a natural cycle, it would be worth testing this approach as a novel strategy in patients with poor implantation after IVF or ICSI.
Key words: human endometrium/microarray/implantation window/biomarkers
Submitted on August 5, 2008; resubmitted on September 5, 2008; accepted on September 10, 2008.
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