Endometrial Heparin-binding Epidermal Growth Factor Expression

Women with PCOS comprise a majority of fertility clinic attendees. Unfortunately, a high failure rate following fertility treatment was observed especially in obese women due to implantation failure. The local study on PCOS women has shown significant changes in an endometrial tumor - regulatory genes but not focusing on the endometrial implantation failure. Many previous attempts using human chorionic gonadotrophin (HCG) infused embryo, gonadotrophin agonist therapy or progesterone support aiming to improve implantation failure in the assisted reproductive technique still unable to enhance pregnancy rate beyond 40% despite a higher' fertilization rate up to 95%. There is still a research gap on what makes obese PCOS women prone to coincides with implantation failure. Endometrial component related to the expression of growth factors play an integral role in establishing cellular context necessary for successful pregnancy. Thus, a new fundamental knowledge on endometrial specific heparin-binding epidermal growth factor expression in the obese PCOS women is vitally important, not only to predict implantation failure but a potential therapy to improve pregnancy outcome.

Sex

Female

Minimum age

18 Years

Maximum age

40 Years

The inclusion criteria for the study group are:

1. All patients between the aged of 18 to 40 years.
2. Women diagnosed with polycystic ovarian syndrome fulfilling two out of three Rotterdam criteria (ie, oligo- or anovulation, hyperandrogenism, and polycystic ovaries on ultrasound).
3. Healthy volunteer with confirmed fertility (having at least one child previously), with a normal level of basic reproductive hormones and regular interval of the menstrual cycle (26 to 32 days). (Control group)

The exclusion criteria are:

1. Smoking
2. any hormonal treatment or other drugs to treat anovulation for at least 3 months before the study
3. Pregnancy or lactation during the preceding 12 months
4. Systemic disease such as endocrine or eating disorders besides PCOS
5. Diagnosed with a uterine or ovarian disease.
6. Any regular medication such as hormones, herbal substance, statins or corticoids for at least 3 months before the study.
7. History of intrauterine device placement.

The inclusion criteria for the control group are:

1. All patients between the aged of 18 to 40 years.
2. Healthy volunteer with confirmed fertility (having at least one child previously), with a normal level of basic reproductive hormones and regular interval of the menstrual cycle (26 to 32 days).

The exclusion criteria are:

1. Smoking
2. any hormonal treatment or other drugs to treat anovulation for at least 3 months before the study
3. Pregnancy or lactation during the preceding 12 months
4. Systemic disease such as endocrine or eating disorders besides PCOS
5. Diagnosed with a uterine or ovarian disease.
6. Any regular medication such as hormones, herbal substance, statins or corticoids for at least 3 months before the study.
7. History of intrauterine device placement.

• BACKGROUNDMengling S, Xian X, Yongli L, et al. Expression of heparin-binding epidermal growth factor in the endometrium is positively correlated with IVF-ET pregnancy outcome. Int J Clin Exp Pathol 2016;9(8):8280-8285.
• RESULTFauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, Carmina E, Chang J, Yildiz BO, Laven JS, Boivin J, Petraglia F, Wijeyeratne CN, Norman RJ, Dunaif A, Franks S, Wild RA, Dumesic D, Barnhart K. Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2012 Jan;97(1):28-38.e25. doi: 10.1016/j.fertnstert.2011.09.024. Epub 2011 Dec 6. PMID 22153789
• RESULTJoham AE, Boyle JA, Ranasinha S, Zoungas S, Teede HJ. Contraception use and pregnancy outcomes in women with polycystic ovary syndrome: data from the Australian Longitudinal Study on Women's Health. Hum Reprod. 2014 Apr;29(4):802-8. doi: 10.1093/humrep/deu020. Epub 2014 Feb 18. PMID 24549213
• RESULTBellver J, Martinez-Conejero JA, Labarta E, Alama P, Melo MA, Remohi J, Pellicer A, Horcajadas JA. Endometrial gene expression in the window of implantation is altered in obese women especially in association with polycystic ovary syndrome. Fertil Steril. 2011 Jun;95(7):2335-41, 2341.e1-8. doi: 10.1016/j.fertnstert.2011.03.021. Epub 2011 Apr 9. PMID 21481376
• RESULTSchulte MM, Tsai JH, Moley KH. Obesity and PCOS: the effect of metabolic derangements on endometrial receptivity at the time of implantation. Reprod Sci. 2015 Jan;22(1):6-14. doi: 10.1177/1933719114561552. Epub 2014 Dec 7. PMID 25488942
• RESULTDeUgarte DA, DeUgarte CM, Sahakian V. Surrogate obesity negatively impacts pregnancy rates in third-party reproduction. Fertil Steril. 2010 Feb;93(3):1008-10. doi: 10.1016/j.fertnstert.2009.07.1005. Epub 2009 Sep 5. PMID 19733847
• RESULTPiltonen TT. Polycystic ovary syndrome: Endometrial markers. Best Pract Res Clin Obstet Gynaecol. 2016 Nov;37:66-79. doi: 10.1016/j.bpobgyn.2016.03.008. Epub 2016 Apr 1.