Heterogeneity of eutopic endometrium in endometriosis: Implications for fertility

Carolyn Jones, Douglas L. Miller, John Aplin, Luciano G. Nardo
In: Jones, C, Miller, D L, Aplin, J & Nardo, L 2011, Heterogeneity of eutopic endometrium in endometriosis: Implications for fertility. Nova Science Publishers. · 2011 · W2605327422
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Endometriosis is associated with morphological and glycan expression heterogeneity in the eutopic endometrium, potentially impairing epithelial differentiation and contributing to fertility issues.

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Abstract

In order for embryo implantation to occur, there must be synchronisation between the development of the blastocyst and the differentiating endometrium, which is refractory to implantation for all but about four days of the menstrual cycle. Hormonally-primed changes affecting the morphology and surface composition of luminal epithelial cells regulate receptivity. The luminal epithelial surface is rich in glycoconjugates, some of which are extremely sensitive to priming.Endometriosis is known to impair fertility. To evaluate the role of the epithelium, we have compared ultrastructure and glycan expression in eutopic endometrium from women with endometriosis and healthy fertile controls. Ultrastructural examination revealed great morphological heterogeneity in the endometriotic biopsies, especially during the mid-late secretory phase. Mitotic figures were evident in gland cells much later in the cycle than normal while, in contrast, other specimens showed accelerated maturation. Heterogeneity was seen between different areas of the same biopsy as well as between biopsies taken at the same phase of the cycle. Glycosylation was also altered, with glycans recognised by Dolichos biflorus agglutinin diminished during the mid-late secretory phase of the cycle in the most severe form of pelvic endometriosis (stage IV). Earlier stages (I - III) showed heterogeneity in glycan expression; some biopsies showed a decrease and others an increase in detectable glycan. The related shorter glycans bound by the lectin from Vicia villosa were not affected to the same extent. It appears, therefore, that endometriosis is associated with an impairment of normal epithelial differentiation, resulting in morphological and biochemical heterogeneity. The resultant asynchrony between an implanting blastocyst and the endometrium may be a contributory factor in early pregnancy failure in women with endometriosis. © 2010 Nova Science Publishers, Inc. All rights reserved.

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endometriosis

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