HYDROSALPINGES ADVERSELY AFFECT MARKERS OF ENDOMETRIAL RECEPTIVITY

While in-vitro fertilization (IVF) was initially developed in women wi th tubal factor infertility, recent clinical studies have suggested th at the presence of hydrosalpinges lowers implantation and pregnancy ra tes, We postulated that these hydrosalpinges cause impaired endometria l receptivity, A total of 103 women with hydrosalpinges were prospecti vely evaluated, and compared with 55 infertile and 44 fertile controls . All women had endometrial biopsies during the window of implantation , analysed by conventional histological criteria, and also stained for three integrin markers of endometrial receptivity (alpha 1 beta 1, al pha 4 beta 1 and alpha v beta 3), women with hydrosalpinges (cases) ex pressed significantly less of the alpha v beta 3 integrin compared wit h controls, There was no difference in expression of alpha 1 beta 1 or alpha 4 beta 1 among groups, A significantly greater number of cases had out of phase histology and missing alpha 1 beta 3 (type I defects) and absent integrin expression despite normal histological maturation (type II) defects, compared with controls, Of 20 women with impaired endometrial receptivity who were also biopsied after hydrosalpinx surg ery, 70% demonstrated increased alpha v beta 3 expression, Seventy-sev en percent of type I and 57% of type II defects were corrected postope ratively, Using markers of endometrial receptivity, this study demonst rates that inflammatory hydrosalpinges have an adverse effect on endom etrial receptivity, which in some cases may be overcome by surgical tr eatment of the hydrosalpinx.