Molecular evaluation of proliferative-phase endometrium may provide insight about the underlying causes of infertility in women with endometriosis

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This study compared endometrial gene expression in infertile women with endometriosis and fertile controls, finding significant differences in specific genes like CXCL13, somatostatin, and CXCL14.

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The study evaluated whether mid-follicular (proliferative-phase) endometrial gene expression differs between women with endometriosis-related infertility and fertile controls, using a two-stage design: a microarray analysis in 15 women (10 infertile with endometriosis and 5 fertile) followed by qRT-PCR validation of 12 genes in an expanded cohort (27 infertile with endometriosis and 15 fertile). Microarray results showed that stage I–II endometriosis was associated with 23 significantly differentially expressed genes and stage III–IV with 35, compared with fertile controls. However, qRT-PCR found only limited concordance—CXCL13 down-regulation and somatostatin up-regulation with early endometriosis, and CXCL14 down-regulation with advanced endometriosis. The paper explicitly notes the restriction to proliferative-phase endometrium and that only a subset of “promising” microarray genes were tested by qRT-PCR. This paper is centrally about endometriosis — it identifies endometrial gene expression differences in women with endometriosis-related infertility during the proliferative phase and discusses potential links to impaired conception.

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Abstract

PurposeTo determine if endometrial gene expression is different in women with endometriosis-related infertility and fertile women.MethodsProspective study of mid-follicular phase endometrium in 47 subjects in two phases: microarray study of 10 infertile women with endometriosis and five fertile controls, and a quantitative real-time PCR (qRT-PCR) study of 27 infertile women with endometriosis and 15 fertile controls. Gene expression was determined by DNA microarray, and qRT-PCR used for 12 "promising" genes based on the microarray analysis.ResultsCompared to fertile controls, women with stage I-II endometriosis had 23, and women with stage III-IV had 35 genes that were significantly up- or down-regulated by microarray. However, using qRT-PCR, only chemokine ligand (CXCL) 13 was significantly down-regulated and somatostatin was significantly up-regulated with early endometriosis, and only CXCL 14 was significantly down-regulated with advanced endometriosis compared to fertile controls.ConclusionsOur findings indicate that the pattern of gene expression in proliferative-phase endometrium is different when comparing tissue from patients with endometriosis versus fertile controls. Recognition of these endometrial alterations could be helpful to diagnose and stage endometriosis, and may provide insight to explain why conception rates are low in women with endometriosis.
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Abstract

Purpose To determine if endometrial gene expression is different in women with endometriosis-related infertility and fertile women.

Methods

Prospective study of mid-follicular phase endometrium in 47 subjects in two phases: microarray study of 10 infertile women with endometriosis and five fertile controls, and a quantitative real-time PCR (qRT-PCR) study of 27 infertile women with endometriosis and 15 fertile controls. Gene expression was determined by DNA microarray, and qRT-PCR used for 12 “promising” genes based on the microarray analysis.

Results

Compared to fertile controls, women with stage I–II endometriosis had 23, and women with stage III–IV had 35 genes that were significantly up- or down-regulated by microarray. However, using qRT-PCR, only chemokine ligand (CXCL) 13 was significantly down-regulated and somatostatin was significantly up-regulated with early endometriosis, and only CXCL 14 was significantly down-regulated with advanced endometriosis compared to fertile controls.

Conclusions

Our findings indicate that the pattern of gene expression in proliferative-phase endometrium is different when comparing tissue from patients with endometriosis versus fertile controls. Recognition of these endometrial alterations could be helpful to diagnose and stage endometriosis, and may provide insight to explain why conception rates are low in women with endometriosis. Similar content being viewed by others

References

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Condition tags

endometriosisinfertility

MeSH descriptors

Chemokine CXCL13 Endometriosis Endometrium Gene Expression Infertility, Female Adolescent Adult Case-Control Studies Chemokine CXCL13 Chemokine CXCL13 Endometriosis Endometriosis Endometrium Female Follicular Phase Follicular Phase Follicular Phase Humans Infertility, Female Infertility, Female

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