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Hum. Reprod. Advance Access published online on November 12, 2009
Human Reproduction, doi:10.1093/humrep/dep401
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© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Altered glycosylation in peri-implantation phase endometrium in women with stages III and IV endometriosis

D.L. Miller, C.J.P. Jones1, J.D. Aplin and L.G. Nardo

Academic Health Sciences Centre, Maternal and Fetal Health Research Group, University of Manchester, St Mary's Hospital, 5th Floor (Research), Oxford Road, Manchester M13 9WL, UK

1 Correspondence address. Tel: +44-161-701-6953; Fax: +44-161-701-6971; E-mail: carolyn.jones{at}manchester.ac.uk

BACKGROUND: Endometriosis is a common cause of infertility and pelvic pain. Lectin histochemistry has shown that glycan expression is a sensitive marker of differentiation in the normal endometrium. Endometrial biopsies were taken during the implantation window from women with subfertility and advanced (stage III and IV) endometriosis to evaluate specific glycans bound by lectins from Dolichos biflorus agglutinin (DBA) and Vicia villosa agglutinin (VVA), which detect related but distinct glycan sequences regulated by progesterone action.

METHODS: Endometrial tissue from 12 women with subfertility and advanced endometriosis and 11 healthy controls were taken on days 19–24 of the menstrual cycle and processed into either epoxy resin or paraffin wax. Lectin histochemistry was analysed using light microscopy to quantify the amount of glandular reaction product.

RESULTS: There was a significant (P = 0.011) reduction in DBA binding to endometrium from patients with endometriosis compared with controls, which was not seen with VVA (P = 0.135). Three stage IV biopsies and one stage III biopsy completely failed to bind DBA and, of these, three showed moderate glandular binding of VVA. DBA and VVA binding differed significantly (P= 0.0039) in the endometriosis specimens whereas in controls no significant difference was detected (P = 0.812).

CONCLUSION: Secretory phase glycosylation in women with advanced endometriosis differs from that in healthy women with a reduction in fucosylated N-acetylgalactosamine sequences bound by DBA. Shorter VVA-binding glycans are not significantly affected. In addition to indicating abnormalities of epithelial differentiation, these findings may be directly relevant to implantation failure, as blastocyst attachment requires a critical interaction with the epithelial glycocalyx.

Key words: endometriosis/glycosylation/human/implantation window/infertility

Submitted on September 2, 2009; resubmitted on October 21, 2009; accepted on October 22, 2009.


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