Endometrial Integrins

The assessment of endometrial function has lagged far behind other clinical examples in the field of endocrinology. Nevertheless, the importance of the endometrium to the establishment normal pregnancy and the associated biochemical complexities in this tissue makes its study of paramount importance. Integrins are a relatively new family of cell adhesion molecules that appear to undergo fascinating temporal and spatial changes in the endometrium throughout the menstrual cycle and into pregnancy suggesting a direct involvement in the process of embryonic implantation. Two integrins, α4β1 and αvβ3, are coex-pressed on endometrial epithelial cells only during the putative window of implantation, and the aberrant expression of the latter appears to predict infertility. Aberrant expression of the avβ3 integrin is found in women with hormonal inadequacy (luteal phase deficiency) and in women with certain inflammatory states (endometriosis, endometritis, and hydrosalpinges). With no currently accepted methods for the assessment of endometrial receptivity, integrins offer a rational means to investigate such defects in the infertile woman. Further, lessons learned from infertile women may lead the way toward improved diagnosis in “unexplained infertility” and safer and more efficacious means of contraception in the future