Abstract
Endometriosis, a highly prevalent disease among women of reproductive age, is strongly associated with infertility. Conflicting results of some studies have suggested the occurrence of lower implantation rates in women with endometriosis submitted to Assisted Reproduction Treatments (ART), which could be due to endometrial defects, to compromised oocyte quality and/or to the interaction between the endometrium and the embryo. Since implantation is a highly controlled process, alterations in the expression of different molecules that are essential for endometrial receptivity might be involved in impaired natural fertility and potentially impaired ART outcomes. Studies have reported altered gene expression in the endometrium of women with endometriosis, including PGR (progresterone receptor) ITGAV and ITGB3 (±v²3 integrin) and SPP1 (osteopontin), which, together with the HBEGF gene (HB-EGF: Heparin-binding EGF-like growth factor), seem to be involved in the establishment of embryo implantation. There is evidence that progesterone indirectly acts on the endometrial epithelium, stimulating stromal factors such as HB-EGF, which directly regulate ±v²3 integrin in the epithelium. Moreover, osteopontin, an ±v²3 integrin ligand, might be directly regulated by progesterone. Thus, the aim of this study is to evaluate and compare the expression of the PGR, HBEGF, ITGAV, ITGB3 and SPP1 genes and, for those with an altered expression pattern, to quantify their products (PR-A and PR- B, HB-EGF, ±v²3 integrin and osteopontin, respectively) in eutopic endometrium of infertile women with endometriosis and of fertile and infertile controls, during the implantation window.
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