1
|
Bui BN, Ardisasmita AI, van de Vliert FH, Abendroth MS, van Hoesel M, Mackens S, Fuchs SA, Nieuwenhuis EES, Broekmans FJM, Steba GS. Enrichment of cell cycle pathways in progesterone-treated endometrial organoids of infertile women compared to fertile women. J Assist Reprod Genet 2024:10.1007/s10815-024-03173-y. [PMID: 38995509 DOI: 10.1007/s10815-024-03173-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 06/13/2024] [Indexed: 07/13/2024] Open
Abstract
PURPOSE To investigate whether the transcriptome profile differs between progesterone-treated infertile and fertile endometrial organoids. METHODS Endometrial biopsies were obtained from 14 infertile and seven fertile women, after which organoids were generated from isolated epithelial cells. To mimic the secretory phase, organoids were sequentially treated with 17β-estradiol (E2) and progesterone (P4) and subjected to RNA sequencing. Differentially expressed genes (DEGs) were identified using DESeq2 (lfcThreshold = 0, log2 Fold Change ≥ 1.0 or ≤ -1.0), and a principal component analysis (PCA) plot was generated. Functional enrichment analysis was performed by overrepresentation analysis and Gene Set Enrichment Analysis (GSEA). To functionally assess proliferation, OrganoSeg surface measurements were performed before (T0) and after (T1) differentiation of organoids, and T1/T0 ratios were calculated to determine the proliferation rate. RESULTS Although the PCA plot did not show clear clustering of the fertile and infertile samples, 363 significant DEGs (129 upregulated and 234 downregulated) were detected in infertile compared to fertile organoids. Mainly cell cycle processes were highly enriched in infertile organoids. Thus, we hypothesised that proliferative activity during differentiation may be higher in infertile organoids compared to fertile organoids. However, this could not be validated by cell surface measurements. CONCLUSIONS This study revealed that cell cycle processes were enriched in E2/P4-treated infertile endometrial organoids as compared to fertile organoids. This could reflect persistently higher proliferative activity of the endometrial epithelial cells in differentiated infertile organoids compared to fertile organoids. To confirm this hypothesis, further studies are warranted.
Collapse
Affiliation(s)
- B N Bui
- Department of Gynaecology and Reproductive Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | - A I Ardisasmita
- Department of Metabolic Diseases, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - F H van de Vliert
- Department of Gynaecology and Reproductive Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - M S Abendroth
- Department of Gynaecology and Reproductive Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - M van Hoesel
- Department of Gynaecology and Reproductive Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - S Mackens
- Brussels IVF, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - S A Fuchs
- Department of Metabolic Diseases, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - E E S Nieuwenhuis
- Department of Pediatric Gastroenterology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Department of Science, University College Roosevelt, Lange Noordstraat 1, 4331 CB, Middelburg, The Netherlands
| | - F J M Broekmans
- Department of Gynaecology and Reproductive Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Centre for Infertility Care, Dijklander Ziekenhuis, Purmerend, The Netherlands
| | - G S Steba
- Department of Gynaecology and Reproductive Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| |
Collapse
|
2
|
Bui BN, Kukushkina V, Meltsov A, Olsen C, van Hoogenhuijze N, Altmäe S, Mol F, Teklenburg G, de Bruin J, Besselink D, Stevens Brentjens L, Obukhova D, Zamani Esteki M, van Golde R, Romano A, Laisk T, Steba G, Mackens S, Salumets A, Broekmans F. The endometrial transcriptome of infertile women with and without implantation failure. Acta Obstet Gynecol Scand 2024; 103:1348-1365. [PMID: 38520066 PMCID: PMC11168281 DOI: 10.1111/aogs.14822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 01/26/2024] [Accepted: 02/16/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION Implantation failure after transferring morphologically "good-quality" embryos in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) may be explained by impaired endometrial receptivity. Analyzing the endometrial transcriptome analysis may reveal the underlying processes and could help in guiding prognosis and using targeted interventions for infertility. This exploratory study investigated whether the endometrial transcriptome profile was associated with short-term or long-term implantation outcomes (ie success or failure). MATERIAL AND METHODS Mid-luteal phase endometrial biopsies of 107 infertile women with one full failed IVF/ICSI cycle, obtained within an endometrial scratching trial, were subjected to RNA-sequencing and differentially expressed genes analysis with covariate adjustment (age, body mass index, luteinizing hormone [LH]-day). Endometrial transcriptomes were compared between implantation failure and success groups in the short term (after the second fresh IVF/ICSI cycle) and long term (including all fresh and frozen cycles within 12 months). The short-term analysis included 85/107 women (33 ongoing pregnancy vs 52 no pregnancy), excluding 22/107 women. The long-term analysis included 46/107 women (23 'fertile' group, ie infertile women with a live birth after ≤3 embryos transferred vs 23 recurrent implantation failure group, ie no live birth after ≥3 good quality embryos transferred), excluding 61/107 women not fitting these categories. As both analyses drew from the same pool of 107 samples, there was some sample overlap. Additionally, cell type enrichment scores and endometrial receptivity were analyzed, and an endometrial development pseudo-timeline was constructed to estimate transcriptomic deviations from the optimum receptivity day (LH + 7), denoted as ΔWOI (window of implantation). RESULTS There were no significantly differentially expressed genes between implantation failure and success groups in either the short-term or long-term analyses. Principal component analysis initially showed two clusters in the long-term analysis, unrelated to clinical phenotype and no longer distinct following covariate adjustment. Cell type enrichment scores did not differ significantly between groups in both analyses. However, endometrial receptivity analysis demonstrated a potentially significant displacement of the WOI in the non-pregnant group compared with the ongoing pregnant group in the short-term analysis. CONCLUSIONS No distinct endometrial transcriptome profile was associated with either implantation failure or success in infertile women. However, there may be differences in the extent to which the WOI is displaced.
Collapse
Affiliation(s)
- Bich Ngoc Bui
- Department of Gynecology and Reproductive MedicineUniversity Medical Center UtrechtUtrechtThe Netherlands
| | | | - Alvin Meltsov
- Competence Center on Health TechnologiesTartuEstonia
- Department of Obstetrics and Gynecology, GROW, School for Oncology and ReproductionMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Catharina Olsen
- Center for Medical Genetics, Research Group Reproduction and GeneticsVrije Universiteit BrusselBrusselsBelgium
- Brussels Interuniversity Genomics High Throughput Core (BRIGHTcore)VUB‐ULBBrusselsBelgium
- Interuniversity Institute of Bioinformatics in Brussels (IB)BrusselsBelgium
| | - Nienke van Hoogenhuijze
- Department of Gynecology and Reproductive MedicineUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Signe Altmäe
- Department of Biochemistry and Molecular Biology, Faculty of SciencesUniversity of GranadaGranadaSpain
- Instituto de Investigación Biosanitaria, ibs.GRANADAGranadaSpain
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC)Karolinska Institute and Karolinska University HospitalStockholmSweden
| | - Femke Mol
- Center for Reproductive Medicine, Reproduction and Development, Amsterdam University Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
| | | | - Jan‐Peter de Bruin
- Department of Obstetrics and GynecologyJeroen Bosch Hospital‘s‐HertogenboschThe Netherlands
| | - Dagmar Besselink
- Department of Obstetrics and GynecologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Linda Stevens Brentjens
- Department of Obstetrics and Gynecology, GROW, School for Oncology and ReproductionMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Darina Obukhova
- Department of Clinical GeneticsMaastricht University Medical CenterMaastrichtThe Netherlands
- Department of Genetics and Cell Biology, GROW School for Oncology and ReproductionMaastricht UniversityMaastrichtThe Netherlands
| | - Masoud Zamani Esteki
- Department of Clinical GeneticsMaastricht University Medical CenterMaastrichtThe Netherlands
- Department of Genetics and Cell Biology, GROW School for Oncology and ReproductionMaastricht UniversityMaastrichtThe Netherlands
| | - Ron van Golde
- Department of Obstetrics and Gynecology, GROW, School for Oncology and ReproductionMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Andrea Romano
- Department of Obstetrics and Gynecology, GROW, School for Oncology and ReproductionMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Triin Laisk
- Estonian Genome Center, Institute of GenomicsUniversity of TartuTartuEstonia
| | - Gaby Steba
- Department of Gynecology and Reproductive MedicineUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Shari Mackens
- Brussels IVFUniversitair Ziekenhuis Brussel, Vrije Universiteit BrusselBrusselsBelgium
| | - Andres Salumets
- Competence Center on Health TechnologiesTartuEstonia
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC)Karolinska Institute and Karolinska University HospitalStockholmSweden
- Department of Obstetrics and Gynecology, Institute of Clinical MedicineUniversity of TartuTartuEstonia
| | - Frank Broekmans
- Department of Gynecology and Reproductive MedicineUniversity Medical Center UtrechtUtrechtThe Netherlands
- Center for Infertility Care, Dijklander HospitalPurmerendThe Netherlands
| |
Collapse
|
3
|
Zhang H, Kong L, Cao Z, Zhu Y, Jiang Y, Wang X, Jiang R, Liu Y, Zhou J, Kang Y, Zhen X, Kong N, Wu M, Yan G, Sun H. EHD1 impaired decidualization of endometrial stromal cells in recurrent implantation failure: role of SENP1 in modulating progesterone receptor signalling†. Biol Reprod 2024; 110:536-547. [PMID: 38011671 DOI: 10.1093/biolre/ioad161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/13/2023] [Accepted: 11/25/2023] [Indexed: 11/29/2023] Open
Abstract
Recurrent implantation failure (RIF) patients exhibit poor endometrial receptivity and abnormal decidualization with reduced effectiveness and exposure to progesterone, which is an intractable clinical problem. However, the associated molecular mechanisms remain elusive. We found that EH domain containing 1 (EHD1) expression was abnormally elevated in RIF and linked to aberrant endometrial decidualization. Here we show that EHD1 overexpressed in human endometrial stromal cells significantly inhibited progesterone receptor (PGR) transcriptional activity and the responsiveness to progesterone. No significant changes were observed in PGR mRNA levels, while a significant decrease in progesterone receptor B (PRB) protein level. Indeed, EHD1 binds to the PRB protein, with the K388 site crucial for this interaction. Overexpression of EHD1 promotes the SUMOylation and ubiquitination of PRB, leading to the degradation of the PRB protein. Supplementation with the de-SUMOylated protease SENP1 ameliorated EHD1-repressed PRB transcriptional activity. To establish a functional link between EHD1 and the PGR signalling pathway, sg-EHD1 were utilized to suppress EHD1 expression in HESCs from RIF patients. A significant increase in the expression of prolactin and insulin-like growth factor-binding protein 1 was detected by interfering with the EHD1. In conclusion, we demonstrated that abnormally high expression of EHD1 in endometrial stromal cells attenuated the activity of PRB associated with progesterone resistance in a subset of women with RIF.
Collapse
Affiliation(s)
- Hui Zhang
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, China
| | - Liping Kong
- Nanjing Vocational Health College, Nanjing, China
| | - Zhiwen Cao
- Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, China
| | - Yinchun Zhu
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Yue Jiang
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Xiaoying Wang
- Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, China
| | - Ruiwei Jiang
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, China
| | - Yang Liu
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, China
| | - Jidong Zhou
- Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, China
| | - Yu Kang
- Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, China
| | - Xin Zhen
- Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, China
| | - Na Kong
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Min Wu
- Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, China
| | - Guijun Yan
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, China
| | - Haixiang Sun
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, China
| |
Collapse
|
4
|
Bui BN, Ardisasmita AI, Kuijk E, Altmäe S, Steba G, Mackens S, Fuchs S, Broekmans F, Nieuwenhuis E. An unbiased approach of molecular characterization of the endometrium: toward defining endometrial-based infertility. Hum Reprod 2024; 39:275-281. [PMID: 38099857 PMCID: PMC10833067 DOI: 10.1093/humrep/dead257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/01/2023] [Indexed: 02/02/2024] Open
Abstract
Infertility is a complex condition affecting millions of couples worldwide. The current definition of infertility, based on clinical criteria, fails to account for the molecular and cellular changes that may occur during the development of infertility. Recent advancements in sequencing technology and single-cell analysis offer new opportunities to gain a deeper understanding of these changes. The endometrium has a potential role in infertility and has been extensively studied to identify gene expression profiles associated with (impaired) endometrial receptivity. However, limited overlap among studies hampers the identification of relevant downstream pathways that could play a role in the development of endometrial-related infertility. To address these challenges, we propose sequencing the endometrial transcriptome of healthy and infertile women at the single-cell level to consistently identify molecular signatures. Establishing consensus on physiological patterns in endometrial samples can aid in identifying deviations in infertile patients. A similar strategy has been used with great success in cancer research. However, large collaborative initiatives, international uniform protocols of sample collection and processing are crucial to ensure reliability and reproducibility. Overall, the proposed approach holds promise for an objective and accurate classification of endometrial-based infertility and has the potential to improve diagnosis and treatment outcomes.
Collapse
Affiliation(s)
- Bich Ngoc Bui
- Department of Gynaecology and Reproductive Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Ewart Kuijk
- Department of Pediatric Gastroenterology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Signe Altmäe
- Department of Biochemistry and Molecular Biology, Faculty of Sciences, University of Granada, Granada, Spain
| | - Gaby Steba
- Department of Gynaecology and Reproductive Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Shari Mackens
- Brussels IVF, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Sabine Fuchs
- Department of Metabolic Diseases, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank Broekmans
- Department of Gynaecology and Reproductive Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
- Centre for Infertility Care, Dijklander Ziekenhuis, Purmerend, The Netherlands
| | - Edward Nieuwenhuis
- Department of Pediatric Gastroenterology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Science, University College Roosevelt, Middelburg, The Netherlands
| |
Collapse
|
5
|
Zhang H, Zhang C, Zhang S. Single-Cell RNA Transcriptome of the Human Endometrium Reveals Epithelial Characterizations Associated with Recurrent Implantation Failure. Adv Biol (Weinh) 2024; 8:e2300110. [PMID: 37690851 DOI: 10.1002/adbi.202300110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/18/2023] [Indexed: 09/12/2023]
Abstract
Recurrent implantation failure (RIF) remains a complex and poorly characterized disorder despite significant advancements in assisted reproductive technology. This study utilizes single-cell transcriptome sequencing (scRNA-seq) to characterize the mid-secretory endometrium of RIF patients. Stromal fibroblast-enriched and epithelium-enriched populations are collected using a two-step dissociation process. After quality control, 25,315 individual cells from 3 RIF patients are analyzed. The analysis identifies 12 distinct cell types, including 6 subtypes of epithelial cells. Significantly, the study reveals the replacement of glandular epithelia with MAP2K6+ EPCAMDIM epithelia in the endometrial glands of RIF patients. Furthermore, the study demonstrates that endometrial gland organoids derived from RIF patients exhibit diminished responses to sex steroids compared to the controls. Single-cell regulatory network inference and clustering (SCENIC) analysis identifies cell-specific cis-regulatory elements and constructed regulatory networks in both groups, showing alterations gene-regulatory networks in RIF patients. Cell-cell communication analysis distinguishes intercellular communication between the two groups, shedding light on disrupted cellular interactions associated with RIF. In summary, these findings provide valuable insights into the cellular and molecular mechanisms underlying RIF, highlighting the roles of epithelial cells in the implantation process.
Collapse
Affiliation(s)
- Hong Zhang
- The Center for Reproductive Medicine, Obstetrics and Gynecology Department, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, P. R. China
| | - Chanyu Zhang
- The Center for Reproductive Medicine, Obstetrics and Gynecology Department, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, P. R. China
- Joint International Research Laboratory for Reproduction and Development of Ministry of Education of China, Chongqing Medical University, Chongqing, 400010, P. R. China
| | - Shen Zhang
- The Center for Reproductive Medicine, Obstetrics and Gynecology Department, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, P. R. China
- Joint International Research Laboratory for Reproduction and Development of Ministry of Education of China, Chongqing Medical University, Chongqing, 400010, P. R. China
| |
Collapse
|
6
|
Taylor AH, Konje JC, Ayakannu T. Identification of Potentially Novel Molecular Targets of Endometrial Cancer Using a Non-Biased Proteomic Approach. Cancers (Basel) 2023; 15:4665. [PMID: 37760635 PMCID: PMC10527058 DOI: 10.3390/cancers15184665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
The present study was aimed at identifying novel proteins in endometrial cancer (EC), employing proteomic analysis of tissues obtained after surgery. A differential MS-based proteomic analysis was conducted from whole tissues dissected from biopsies from post-menopausal women, histologically confirmed as endometrial cancer (two endometrioid and two serous; n = 4) or normal atrophic endometrium (n = 4), providing 888 differentially expressed proteins with 246 of these previously documented elsewhere as expressed in EC and 372 proteins not previously demonstrated to be expressed in EC but associated with other types of cancer. Additionally, 33 proteins not recorded previously in PubMed as being expressed in any forms of cancer were also identified, with only 26 of these proteins having a publication associated with their expression patterns or putative functions. The putative functions of the 26 proteins (GRN, APP, HEXA, CST3, CAD, QARS, SIAE, WARS, MYH8, CLTB, GOLIM4, SCARB2, BOD1L1, C14orf142, C9orf142, CCDC13, CNPY4, FAM169A, HN1L, PIGT, PLCL1, PMFBP1, SARS2, SCPEP1, SLC25A24 and ZC3H4) in other tissues point towards and provide a basis for further investigation of these previously unrecognised novel EC proteins. The developmental biology, disease, extracellular matrix, homeostatic, immune, metabolic (both RNA and protein), programmed cell death, signal transduction, molecular transport, transcriptional networks and as yet uncharacterised pathways indicate that these proteins are potentially involved in endometrial carcinogenesis and thus may be important in EC diagnosis, prognostication and treatment and thus are worthy of further investigation.
Collapse
Affiliation(s)
- Anthony H. Taylor
- Reproductive Sciences Section, Department of Cancer Studies & Molecular Medicine, University of Leicester, Leicester LE1 7RH, UK; (A.H.T.); (J.C.K.)
- Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, UK
| | - Justin C. Konje
- Reproductive Sciences Section, Department of Cancer Studies & Molecular Medicine, University of Leicester, Leicester LE1 7RH, UK; (A.H.T.); (J.C.K.)
- Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK
- Weill Cornell Medicine-Qatar, Al Rayyan, Doha P.O. Box 24144, Qatar
| | - Thangesweran Ayakannu
- Reproductive Sciences Section, Department of Cancer Studies & Molecular Medicine, University of Leicester, Leicester LE1 7RH, UK; (A.H.T.); (J.C.K.)
- Department of Obstetrics & Gynaecology, Taylor’s University, Subang Jaya 47500, Selangor, Malaysia
- Sunway Medical Centre, Bandar Sunway, Subang Jaya 47500, Selangor, Malaysia
| |
Collapse
|
7
|
Ali R, Iqbal MUN, Rehman R, Khan TA. Interplay of "leukemia inhibitory factor receptor gene" (rs3099124) polymorphism, leukemia inhibitory factor and ovarian steroids with unexplained infertility. NUCLEOSIDES, NUCLEOTIDES & NUCLEIC ACIDS 2023; 42:718-730. [PMID: 36924393 DOI: 10.1080/15257770.2023.2188911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/23/2023] [Accepted: 03/03/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVE OF THE STUDY To explore the association of leukemia inhibitory factor receptor (LIFR) gene variant rs3099124, ovarian steroids, and leukemia inhibitory factor with unexplained infertility in Pakistani females. METHODOLOGY A case-control investigation in which eighty-one (81) females with unexplained infertility and one hundred and sixty-two (162) fertile counterparts (age and body mass index compared) were recruited between October 2016 and 2018. Ten milliliters of venous blood was collected from all participants. "Genomic DNA" was taken out from lymphocytes in peripheral blood samples. "Tetra Amplification Refractory Mutation System Polymerase Chain Reaction (T-ARMS-PCR)" was constructed through software "Primer-I". Amplification was carried out by "T-ARMS-PCR" followed by subsequent sequencing for confirmation and extensive consonance. Estradiol, Progesterone and Leukemia Inhibitory Factor (LIF) were measured in serum by ELISA. RESULTS Statistically significant difference was noticed in genotype frequency in "LIFR-gene variant; rs3099124" (χ2 = 28.222, P value < 0.01) between research participants. Although, rs "3099124" "AA" (OR = 0.000; 95%CI = 0-0) and "GA" genotypes (OR = 0.525; 95%CI = 0.226-1.22) showed non-significant safety/protection against unexplained infertility yet minor/risk allele "A" frequency was greater in women with unexplained infertility suggesting a possible explanation of implantation failure. LIF concentration varied between fertile and infertile groups (χ2 = 9.857, P < 0.05) revealing significant threat of unexplained infertility in women with decreased LIF concentration (OR = 2.316, 95%CI = 1.214-4.416). Progesterone was significantly related to unexplained infertility in both study groups (χ2 = 20.347, P < 0.05). High progesterone reduced the possibility of unexplained infertility (OR = 0.306; 95% CI = 0.166-0.567). CONCLUSION LIFR gene variation (rs3099124) and reduced LIF secretion may cause implantation failure in women with unexplained infertility.
Collapse
Affiliation(s)
- Rabiya Ali
- Department of Physiology, Karachi Institute of Medical Sciences (KIMS), CMH, Malir Cantt., Karachi, Pakistan
| | | | - Rehana Rehman
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
| | | |
Collapse
|
8
|
The Extracellular Vesicles Proteome of Endometrial Cells Simulating the Receptive Menstrual Phase Differs from That of Endometrial Cells Simulating the Non-Receptive Menstrual Phase. Biomolecules 2023; 13:biom13020279. [PMID: 36830648 PMCID: PMC9953153 DOI: 10.3390/biom13020279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/23/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
Successful embryo implantation into a receptive endometrium requires mutual endometrial-embryo communication. Recently, the function of extracellular vehicles (EVs) in cell-to-cell interaction in embryo-maternal interactions has been investigated. We explored isolated endometrial-derived EVs, using RL95-2 cells as a model of a receptive endometrium, influenced by the menstrual cycle hormones estrogen (E2; proliferative phase), progesterone (P4; secretory phase), and estrogen plus progesterone (E2P4; the receptive phase). EV sized particles were isolated by differential centrifugation and size exclusion chromatography. Nanoparticle tracking analysis was used to examine the different concentrations and sizes of particles and EV proteomic analysis was performed using shotgun label-free mass spectrometry. Our results showed that although endometrial derived EVs were secreted in numbers independent of hormonal stimulation, EV sizes were statistically modified by it. Proteomics analysis showed that hormone treatment changes affect the endometrial EV's proteome, with proteins enhanced within the EV E2P4 group shown to be involved in different processes, such as embryo implantation, endometrial receptivity, and embryo development, supporting the concept of a communication system between the embryo and the maternal endometrium via EVs.
Collapse
|
9
|
Farag AH, Farid A, Nasr El-Din MH, Mohamed MA, El-Helaly AM. Serum and cervico-vaginal glycodelin concentrations as predictors of successful implantation after embryo transfer. Taiwan J Obstet Gynecol 2022; 61:464-471. [PMID: 35595439 DOI: 10.1016/j.tjog.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Evaluation of glycodelin (Gd) concentrations in serum and cervico-vaginal secretions as a predictor for implantation after ICSI. MATERIALS AND METHODS Prospective study on 50 women undergoing ICSI where long protocol ovarian stimulation was used. Serum and cervico-vaginal lavage Gd concentrations were measured then rates of biochemical and clinical pregnancy were detected and predictive value was evaluated using logistic regression analysis. RESULTS Using cut-off values of 2.2 ng/ml and 1.9 ng/ml for serum and cervico-vaginal Gd concentrations respectively for biochemical pregnancy and values of 2.7 ng/ml and 1.3 ng/ml respectively for clinical pregnancy, there was no significant difference regarding sensitivity (72% & 56%, and 72% & 89%, respectively and respectively). Specificity was statistically similar for biochemical pregnancy (72% and 89%, respectively) while specificity was significantly higher for clinical pregnancy using cervico-vaginal Gd concentration of 1.3 ng/ml (88%) compared to serum Gd concentration of 1.9 ng/ml (53%). CONCLUSION Glycodelin appears to be a promising marker for implantation after IVF/ICSI.
Collapse
Affiliation(s)
- Amr H Farag
- Department of Obstetrics and Gynaecology, Ain Shams University, Cairo, Egypt.
| | - Ali Farid
- Department of Obstetrics and Gynaecology, Ain Shams University, Cairo, Egypt
| | | | - Marwa A Mohamed
- Department of Obstetrics and Gynaecology, Ain Shams University, Cairo, Egypt
| | - Amr M El-Helaly
- Department of Obstetrics and Gynaecology, Ain Shams University, Cairo, Egypt
| |
Collapse
|
10
|
Ali R, Iqbal MUN, Rehman R, Khan TA. Association of novel stop-gained leukaemia inhibitory factor receptor gene (rs121912501) variant, leukaemia inhibitory factor and ovarian steroids with unexplained infertility among Pakistani women. Int J Clin Pract 2021; 75:e14245. [PMID: 33914392 DOI: 10.1111/ijcp.14245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 11/30/2022] Open
Abstract
AIMS AND OBJECTIVES Embryo implantation is a complex process that requires sequential steps at the interface of embryo interaction with decidual endometrium. Many women after experiencing multiple attempts of assisted reproductive techniques fail to get implantation because of instability of leukaemia inhibitory factor and leukaemia inhibitory factor receptor-signal transducer and activator of transcription factor 3 (LIF-LIFR STAT3) signalling cascade. Therefore, this study explores the association of ovarian steroids, LIF and LIFR stop-gained variant using the tetra primer amplification refractory mutation system-polymerase chain reaction (TARMS-PCR) with unexplained infertility (UEX-IF) among Pakistani women. MATERIALS AND METHODS This is a case-control study, a total of 81 unexplained infertile women and 162 fertile controls (with age and BMI matched) were inducted. Serum estradiol, progesterone and LIF were determined using enzyme-linked immunosorbent assay (ELISA). T-ARMS-PCR was designed using Primer 1 software. Genomic DNA was extracted from peripheral blood and amplified using T-ARMS-PCR followed by sequencing for validation and comprehensive concordance. RESULTS This study established differences in LIF levels (χ2 = 9.857, P < .05) between patients and controls as well as explored the decreased LIF significantly raised the risk of UEX-IF (OR = 2.316; 95% CI = 1.214, 4.416). Progesterone (P) was significantly associated with UEX-IF between fertile and infertile counterparts (χ2 = 20.347, P < .05). It was also observed that increased Progesterone reduced the risk of UEX-IF (OR = 0.306; 95% CI = 0.166, 0.567). A rapid and inexpensive method for genotyping novel LIFR gene polymorphism through T- ARMS-PCR was successfully developed. LIFR gene SNP (rs121912501) had significant association (χ2 = 200.681, P < .05) with UEX-IF. LIFR rs121912501 "TT" genotype (OR = 5.417; 95% CI = 1.868, 15.709) and "CT" genotype (OR = 3.104, 95% CI = 1.586,6.076) were at increased risk of infertility. CONCLUSION UEX-IF can be caused by LIFR gene variation irrespective of increased P. It may open the doors for the discovery of new management plans for infertile women.
Collapse
Affiliation(s)
- Rabiya Ali
- Department of Physiology, Karachi Institute of Medical Sciences (KIMS), CMH, Malir Cantt, Karachi, Pakistan
| | | | - Rehana Rehman
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
| | - Taseer A Khan
- Department of Physiology, University of Karachi, Karachi, Pakistan
| |
Collapse
|
11
|
Sebastian-Leon P, Devesa-Peiro A, Aleman A, Parraga-Leo A, Arnau V, Pellicer A, Diaz-Gimeno P. Transcriptional changes through menstrual cycle reveal a global transcriptional derepression underlying the molecular mechanism involved in the window of implantation. Mol Hum Reprod 2021; 27:6217366. [PMID: 33830236 DOI: 10.1093/molehr/gaab027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/27/2021] [Indexed: 12/20/2022] Open
Abstract
The human endometrium is a dynamic tissue that only is receptive to host the embryo during a brief time in the middle secretory phase, called the window of implantation (WOI). Despite its importance, regulation of the menstrual cycle remains incompletely understood. The aim of this study was to characterize the gene cooperation and regulation of menstrual cycle progression, to dissect the molecular complexity underlying acquisition of endometrial receptivity for a successful pregnancy, and to provide the scientific community with detailed gene co-expression information throughout the menstrual cycle on a user-friendly web-tool database. A retrospective gene co-expression analysis was performed based on the endometrial receptivity array (ERarray) gene signature from 523 human endometrial samples collected across the menstrual cycle, including during the WOI. Gene co-expression analysis revealed the WOI as having the significantly smallest proportion of negative correlations for transcriptional profiles associated with successful pregnancies compared to other cycle stages, pointing to a global transcriptional derepression being involved in acquisition of endometrial receptivity. Regulation was greatest during the transition between proliferative and secretory endometrial phases. Further, we prioritized nuclear hormone receptors as major regulators of this derepression and proved that some genes and transcription factors involved in this process were dysregulated in patients with recurrent implantation failure. We also compiled the wealth of gene co-expression data to stimulate hypothesis-driven single-molecule endometrial studies in a user-friendly database: Menstrual Cycle Gene Co-expression Network (www.menstrualcyclegcn.com). This study revealed a global transcriptional repression across the menstrual cycle, which relaxes when the WOI opens for transcriptional profiles associated with successful pregnancies. These findings suggest that a global transcriptional derepression is needed for embryo implantation and early development.
Collapse
Affiliation(s)
- P Sebastian-Leon
- Department of Genomic & Systems Reproductive Medicine, IVI-RMA IVI Foundation-Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - A Devesa-Peiro
- Department of Genomic & Systems Reproductive Medicine, IVI-RMA IVI Foundation-Instituto de Investigación Sanitaria La Fe, Valencia, Spain.,Department of Pediatrics, Obstetrics and Gynaecology, University of Valencia, Valencia, Spain
| | - A Aleman
- Department of Genomic & Systems Reproductive Medicine, IVI-RMA IVI Foundation-Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - A Parraga-Leo
- Department of Genomic & Systems Reproductive Medicine, IVI-RMA IVI Foundation-Instituto de Investigación Sanitaria La Fe, Valencia, Spain.,Department of Pediatrics, Obstetrics and Gynaecology, University of Valencia, Valencia, Spain
| | - V Arnau
- Bioinformatics, Escuela Técnica Superior de Ingeniería, Universidad de Valencia, Burjassot, Spain.,Institute for Integrative Systems Biology (I2SysBio), Universidad de Valencia-Consejo Superior de Investigaciones Científicas (CSIC), C/Catedrático Agustín Escardino Benlloch, Paterna, Spain
| | - A Pellicer
- Department of Genomic & Systems Reproductive Medicine, IVI-RMA IVI Foundation-Instituto de Investigación Sanitaria La Fe, Valencia, Spain.,Department of Pediatrics, Obstetrics and Gynaecology, University of Valencia, Valencia, Spain.,Reproductive Medicine, IVI-RMA IVI Rome, Rome, Italy
| | - P Diaz-Gimeno
- Department of Genomic & Systems Reproductive Medicine, IVI-RMA IVI Foundation-Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| |
Collapse
|
12
|
Crosby DA, Glover LE, Downey P, Mooney EE, McAuliffe FM, O'Farrelly C, Brennan DJ, Wingfield M. The impact of accurately timed mid-luteal endometrial injury in nulligravid women undergoing their first or second embryo transfer. Ir J Med Sci 2020; 190:1071-1077. [PMID: 33090349 DOI: 10.1007/s11845-020-02414-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 10/17/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Endometrial injury or 'scratch' preceding an assisted reproductive therapy (ART) cycle has recently been shown not to improve livebirth rates among women undergoing ART. The objective of this study was to compare pregnancy outcomes in nulliparous women who underwent an accurately timed mid-luteal scratch biopsy prior to ART with those who did not. METHODS This was a prospective cohort study. Women were recruited between October 2016 and February 2018 inclusive. Women who met the inclusion criteria and who did not undergo an endometrial scratch in the study period were used as a comparison group. Patients underwent a cycle of ART in the menstrual cycle following endometrial scratch. RESULTS Ninety-eight women were eligible for participation in the study. There were no differences in rates of implantation (35.7% (n = 20/56) vs. 35.4% (n = 17/48); p = 1.00), clinical pregnancy (40.0% (n = 20/50) vs. 39.5% (n = 17/43); p = 1.00) or live birth (34.0% (n = 17/50) vs. 25.6% (n = 11/43); p = 0.50) per embryo transfer between those who underwent a scratch and those who did not. CONCLUSION Endometrial scratch is a simple, inexpensive and low-risk procedure. However, in this relatively small cohort study, no differences in rates of implantation, clinical pregnancy or live birth in women with primary infertility were determined between those who underwent a scratch and those who did not.
Collapse
Affiliation(s)
- David A Crosby
- Merrion Fertility Clinic, 60 Mount Street, Dublin 2, Ireland. .,UCD Obstetrics & Gynaecology, National Maternity Hospital, University College Dublin, Dublin 2, Ireland.
| | - Louise E Glover
- Merrion Fertility Clinic, 60 Mount Street, Dublin 2, Ireland.,School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Paul Downey
- Department of Pathology and Laboratory Medicine, National Maternity Hospital, Dublin, Ireland
| | - Eoghan E Mooney
- Department of Pathology and Laboratory Medicine, National Maternity Hospital, Dublin, Ireland
| | - Fionnuala M McAuliffe
- UCD Obstetrics & Gynaecology, National Maternity Hospital, University College Dublin, Dublin 2, Ireland
| | - Cliona O'Farrelly
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Donal J Brennan
- UCD Obstetrics & Gynaecology, National Maternity Hospital, University College Dublin, Dublin 2, Ireland
| | - Mary Wingfield
- Merrion Fertility Clinic, 60 Mount Street, Dublin 2, Ireland.,UCD Obstetrics & Gynaecology, National Maternity Hospital, University College Dublin, Dublin 2, Ireland.,School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
13
|
Pathophysiological Basis of Endometriosis-Linked Stress Associated with Pain and Infertility: A Conceptual Review. REPRODUCTIVE MEDICINE 2020. [DOI: 10.3390/reprodmed1010004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Women with endometriosis are often under stress due to the associated pain, infertility, inflammation-related and other comorbidities including cancer. Additionally, these women are also under stress due to taboos, myths, inter-personal troubles surrounding infertility and pain of the disease as well as due to frequent incidences of missed diagnosis and treatment recurrence. Often these women suffer from frustration and loss of valuable time in the prime phase of life. All these complexities integral to endometriosis posit a hyperstructure of integrative stress physiology with overt differentials in effective allostatic state in women with disease compared with disease-free women. In the present review, we aim to critically examine various aspects of pathophysiological basis of stress surrounding endometriosis with special emphasis on pain and subfertility that are known to affect the overall health and quality of life of women with the disease and promising pathophysiological basis for its effective management.
Collapse
|
14
|
Braga DPDAF, Setti AS, Iaconelli A, Borges E. Predictive factors for successful pregnancy in an egg-sharing donation program. JBRA Assist Reprod 2020; 24:163-169. [PMID: 32157861 PMCID: PMC7169914 DOI: 10.5935/1518-0557.20190087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective To investigate the predictive factors for successful pregnancy in oocyte recipient ICSI cycles in an egg-sharing donation program. Methods Analysed data were obtained via chart review of 1505 vitrified oocytes donated from 268 patients to 225 oocyte recipients, undergoing 307 ICSI cycles. Patients were participating in an egg-sharing donation program between January 2015 and May 2017. Adjusted generalised linear models were used to investigate the impact of oocyte donor and recipient characteristics on recipients’ pregnancy achievement. Results Implantation rate in the oocyte donor was highly correlated with pregnancy achievement in the oocyte recipient’s cycles (ExpB: 1.181, CI: 1.138-1.226, p<0.001). The ROC curve analysis demonstrated that the implantation rate in the oocyte donor has a strong predictive value for pregnancy success in the oocyte recipient (area under the curve: 0.98, CI: 0.95-0.99, p<0.001). Pregnancy in oocyte donors and recipients were highly associated (ExpB: 54.6, CI: 28.1-105.8, p<0.001), regardless of the oocyte recipient’s age. In oocyte recipients, the high-quality embryos rates on days 2 (ExpB: 3.397, CI: 1.635-7.054, p=0.001) and 3 (ExpB: 6.629, CI: 1.185-37.092, p=0.031), and blastocyst development rates (ExpB: 2.331, CI: 1.086-5.001, p=0.030) were positively associated with pregnancy outcome. Conclusion The strong association in pregnancy success between donors and recipients, and the lack of correlation between donor characteristics and cycles’ outcomes, demonstrate the power of oocyte quality on the success of ICSI treatment.
Collapse
Affiliation(s)
| | - Amanda Souza Setti
- Fertility Medical Group, São Paulo, SP, Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida, São Paulo, SP, Brazil
| | - Assumpto Iaconelli
- Fertility Medical Group, São Paulo, SP, Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida, São Paulo, SP, Brazil
| | - Edson Borges
- Fertility Medical Group, São Paulo, SP, Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida, São Paulo, SP, Brazil
| |
Collapse
|
15
|
Kasvandik S, Saarma M, Kaart T, Rooda I, Velthut-Meikas A, Ehrenberg A, Gemzell K, Lalitkumar PG, Salumets A, Peters M. Uterine Fluid Proteins for Minimally Invasive Assessment of Endometrial Receptivity. J Clin Endocrinol Metab 2020; 105:5568227. [PMID: 31512719 DOI: 10.1210/clinem/dgz019] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 09/04/2019] [Indexed: 11/19/2022]
Abstract
CONTEXT Clinically used endometrial (EM) receptivity assays are based on transcriptomic patterning of biopsies at midsecretory endometrium (MSE) to identify the possible displacement or disruption of window of implantation (WOI) in patients with recurrent implantation failure (RIF). However, biopsies are invasive and cannot be performed in the same cycle with in vitro fertilization embryo transfer, while uterine fluid (UF) analysis is considered minimally invasive and can immediately precede embryo transfer. OBJECTIVE To determine whether UF proteome can be used for WOI monitoring and whether it would highlight the etiology of RIF. PATIENTS Paired early secretory endometrial (ESE) and MSE UF samples from six fertile control women for discovery, and an additional 11 paired ESE/MSE samples from controls and 29 MSE samples from RIF patients for validation. RESULTS Using discovery mass spectrometry (MS) proteomics we detected 3158 proteins from secretory phase UF of which 367 undergo significant (q < 0.05) proteomic changes while transitioning from ESE to MSE. Forty-five proteins were further validated with targeted MS, and 21 were found to display similar levels between control ESE and RIF MSE, indicating displacement of the WOI. A panel of PGR, NNMT, SLC26A2 and LCN2 demonstrated specificity and sensitivity of 91.7% for distinguishing MSE from ESE samples. The same panel distinguished control MSE samples from RIF MSE with a 91.7% specificity and 96.6% sensitivity. CONCLUSION UF proteins can be used for estimating uterine receptivity with minimal invasiveness. Women with RIF appear to have altered MSE UF profiles that may contribute to their low IVF success rate.
Collapse
Affiliation(s)
- Sergo Kasvandik
- Proteomics Core Facility, Institute of Technology, University of Tartu, Tartu, Estonia
- Competence Centre on Health Technologies, Tartu, Estonia
| | - Merilin Saarma
- Proteomics Core Facility, Institute of Technology, University of Tartu, Tartu, Estonia
| | - Tanel Kaart
- Institute of Veterinary Medicine and Animal Sciences, Estonian University of Life Sciences, Tartu, Estonia
| | - Ilmatar Rooda
- Competence Centre on Health Technologies, Tartu, Estonia
- Department of Chemistry and Biotechnology, Tallinn University of Technology, Tallinn, Estonia
| | - Agne Velthut-Meikas
- Department of Chemistry and Biotechnology, Tallinn University of Technology, Tallinn, Estonia
| | | | - Kristina Gemzell
- Department of Women's and Children's Health, Karolinska Institutet/Karolinska University Hospital, Stockholm, Sweden
| | - Parameswaran Grace Lalitkumar
- Department of Women's and Children's Health, Karolinska Institutet/Karolinska University Hospital, Stockholm, Sweden
| | - Andres Salumets
- Competence Centre on Health Technologies, Tartu, Estonia
- Department of Obstetrics and Gynecology, University of Tartu, Tartu, Estonia
- Department of Biomedicine, University of Tartu, Tartu, Estonia
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Maire Peters
- Competence Centre on Health Technologies, Tartu, Estonia
- Department of Obstetrics and Gynecology, University of Tartu, Tartu, Estonia
| |
Collapse
|
16
|
Anupa G, Sharma JB, Roy KK, Sengupta J, Ghosh D. An assessment of the multifactorial profile of steroid-metabolizing enzymes and steroid receptors in the eutopic endometrium during moderate to severe ovarian endometriosis. Reprod Biol Endocrinol 2019; 17:111. [PMID: 31878927 PMCID: PMC6933937 DOI: 10.1186/s12958-019-0553-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 12/04/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Previous studies of expression profiles of major endometrial effectors of steroid physiology in endometriosis have yielded markedly conflicting conclusions, presumably because the relative effects of type of endometriosis, fertility history and menstrual cycle phases on the measured variables were not considered. In the present study, endometrial mRNA and protein levels of several effectors of steroid biosynthesis and action in patients with stage III-IV ovarian endometriosis (OE) with known fertility and menstrual cycle histories were compared with the levels in control endometrium to test this concept. METHODS Endometrial samples were collected from patients without endometriosis (n = 32) or OE stages III-IV (n = 52) with known fertility and cycle histories. qRT-PCR and immunoblotting experiments were performed to measure levels of NR5A1, STAR, CYP19A1, HSD17Bs, ESRs and PGR transcripts and proteins, respectively. Tissue concentrations of steroids (P4, T, E1 and E2) were measured using ELISAs. RESULTS The levels of expression of aromatase and ERβ were lower (P < 0.0001) and 17β-HSD1 (P < 0.0001) and PRA (P < 0.01) were higher in OE endometrium. Lower aromatase levels and higher 17β-HSD1 levels were detected in fertile (aromatase: P < 0.05; 17β-HSD1: P < 0.0001) and infertile (aromatase: P < 0.0001; 17β-HSD1: P < 0.0001) OE endometrium than in the matched control tissues. Both proliferative (PP) and secretory (SP) phase OE samples expressed aromatase (P < 0.0001) and ERβ (PP: P < 0.001; SP: P < 0.01) at lower levels and 17β-HSD1 (P < 0.0001) and PRA (PP: P < 0.01; SP: P < 0.0001) at higher levels than matched controls. Higher 17β-HSD1 (P < 0.01) and E2 (P < 0.05) levels and a lower (P < 0.01) PRB/PRA ratio was observed in infertile secretory phase OE endometrium than in control. CONCLUSIONS We report that dysregulated expression of 17β-HSD1 and PGR resulting in hyperestrogenism and progesterone resistance during the secretory phase of the menstrual cycle, rather than an anomaly in aromatase expression, was the hallmark of eutopic endometrium from infertile OE patients. Furthermore, the results provide proof of concept that the fertility and menstrual cycle histories exerted relatively different effects on steroid physiology in the endometrium from OE patients compared with the control subjects.
Collapse
Affiliation(s)
- G. Anupa
- 0000 0004 1767 6103grid.413618.9Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
- 0000 0004 1767 6103grid.413618.9Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
| | - Jai Bhagwan Sharma
- 0000 0004 1767 6103grid.413618.9Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
| | - Kallol K. Roy
- 0000 0004 1767 6103grid.413618.9Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
| | - Jayasree Sengupta
- 0000 0004 1767 6103grid.413618.9Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Debabrata Ghosh
- 0000 0004 1767 6103grid.413618.9Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
17
|
Development and utilization of human decidualization reporter cell line uncovers new modulators of female fertility. Proc Natl Acad Sci U S A 2019; 116:19541-19551. [PMID: 31501330 DOI: 10.1073/pnas.1907652116] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Failure of embryo implantation accounts for a significant percentage of female infertility. Exquisitely coordinated molecular programs govern the interaction between the competent blastocyst and the receptive uterus. Decidualization, the rapid proliferation and differentiation of endometrial stromal cells into decidual cells, is required for implantation. Decidualization defects can cause poor placentation, intrauterine growth restriction, and early parturition leading to preterm birth. Decidualization has not yet been systematically studied at the genetic level due to the lack of a suitable high-throughput screening tool. Herein we describe the generation of an immortalized human endometrial stromal cell line that uses yellow fluorescent protein under the control of the prolactin promoter as a quantifiable visual readout of the decidualization response (hESC-PRLY cells). Using this cell line, we performed a genome-wide siRNA library screen, as well as a screen of 910 small molecules, to identify more than 4,000 previously unrecognized genetic and chemical modulators of decidualization. Ontology analysis revealed several groups of decidualization modulators, including many previously unappreciated transcription factors, sensory receptors, growth factors, and kinases. Expression studies of hits revealed that the majority of decidualization modulators are acutely sensitive to ovarian hormone exposure. Gradient treatment of exogenous factors was used to identify EC50 values of small-molecule hits, as well as verify several growth factor hits identified by the siRNA screen. The high-throughput decidualization reporter cell line and the findings described herein will aid in the development of patient-specific treatments for decidualization-based recurrent pregnancy loss, subfertility, and infertility.
Collapse
|
18
|
Mortlock S, Restuadi R, Levien R, Girling JE, Holdsworth-Carson SJ, Healey M, Zhu Z, Qi T, Wu Y, Lukowski SW, Rogers PAW, Yang J, McRae AF, Fung JN, Montgomery GW. Genetic regulation of methylation in human endometrium and blood and gene targets for reproductive diseases. Clin Epigenetics 2019; 11:49. [PMID: 30871624 PMCID: PMC6416889 DOI: 10.1186/s13148-019-0648-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/06/2019] [Indexed: 02/02/2023] Open
Abstract
Background Major challenges in understanding the functional consequences of genetic risk factors for human disease are which tissues and cell types are affected and the limited availability of suitable tissue. The aim of this study was to evaluate tissue-specific genotype-epigenetic characteristics in DNA samples from both endometrium and blood collected from women at different stages of the menstrual cycle and relate results to genetic risk factors for reproductive traits and diseases. Results We analysed DNA methylation (DNAm) data from endometrium and blood samples from 66 European women. Methylation profiles were compared between stages of the menstrual cycle, and changes in methylation overlaid with changes in transcription and genotypes. We observed large changes in methylation (27,262 DNAm probes) across the menstrual cycle in endometrium that were not observed in blood. Individual genotype data was tested for association with methylation at 443,016 and 443,101 DNAm probes in endometrium and blood respectively to identify methylation quantitative trait loci (mQTLs). A total of 4546 sentinel cis-mQTLs (P < 1.13 × 10−10) and 434 sentinel trans-mQTLs (P < 2.29 × 10−12) were detected in endometrium and 6615 sentinel cis-mQTLs (P < 1.13 × 10−10) and 590 sentinel trans-mQTLs (P < 2.29 × 10−12) were detected in blood. Following secondary analyses, conducted to test for overlap between mQTLs in the two tissues, we found that 62% of endometrial cis-mQTLs were also observed in blood and the genetic effects between tissues were highly correlated. A number of mQTL SNPs were associated with reproductive traits and diseases, including one mQTL located in a known risk region for endometriosis (near GREB1). Conclusions We report novel findings characterising genetic regulation of methylation in endometrium and the association of endometrial mQTLs with endometriosis risk and other reproductive traits and diseases. The high correlation of genetic effects between tissues highlights the potential to exploit the power of large mQTL datasets in endometrial research and identify target genes for functional studies. However, tissue-specific methylation profiles and genetic effects also highlight the importance of also using disease-relevant tissues when investigating molecular mechanisms of disease risk. Electronic supplementary material The online version of this article (10.1186/s13148-019-0648-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Sally Mortlock
- Institute for Molecular Bioscience, The University of Queensland, 306 Carmody Road, Building 80, St Lucia, QLD, 4072, Australia.
| | - Restuadi Restuadi
- Institute for Molecular Bioscience, The University of Queensland, 306 Carmody Road, Building 80, St Lucia, QLD, 4072, Australia
| | - Rupert Levien
- Institute for Molecular Bioscience, The University of Queensland, 306 Carmody Road, Building 80, St Lucia, QLD, 4072, Australia
| | - Jane E Girling
- Department of Obstetrics and Gynaecology, and Gynaecology Research Centre, University of Melbourne, Royal Women's Hospital, Parkville, VIC, 3052, Australia.,Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Sarah J Holdsworth-Carson
- Department of Obstetrics and Gynaecology, and Gynaecology Research Centre, University of Melbourne, Royal Women's Hospital, Parkville, VIC, 3052, Australia
| | - Martin Healey
- Department of Obstetrics and Gynaecology, and Gynaecology Research Centre, University of Melbourne, Royal Women's Hospital, Parkville, VIC, 3052, Australia
| | - Zhihong Zhu
- Institute for Molecular Bioscience, The University of Queensland, 306 Carmody Road, Building 80, St Lucia, QLD, 4072, Australia
| | - Ting Qi
- Institute for Molecular Bioscience, The University of Queensland, 306 Carmody Road, Building 80, St Lucia, QLD, 4072, Australia
| | - Yang Wu
- Institute for Molecular Bioscience, The University of Queensland, 306 Carmody Road, Building 80, St Lucia, QLD, 4072, Australia
| | - Samuel W Lukowski
- Institute for Molecular Bioscience, The University of Queensland, 306 Carmody Road, Building 80, St Lucia, QLD, 4072, Australia
| | - Peter A W Rogers
- Department of Obstetrics and Gynaecology, and Gynaecology Research Centre, University of Melbourne, Royal Women's Hospital, Parkville, VIC, 3052, Australia
| | - Jian Yang
- Institute for Molecular Bioscience, The University of Queensland, 306 Carmody Road, Building 80, St Lucia, QLD, 4072, Australia
| | - Allan F McRae
- Institute for Molecular Bioscience, The University of Queensland, 306 Carmody Road, Building 80, St Lucia, QLD, 4072, Australia
| | - Jenny N Fung
- Institute for Molecular Bioscience, The University of Queensland, 306 Carmody Road, Building 80, St Lucia, QLD, 4072, Australia
| | - Grant W Montgomery
- Institute for Molecular Bioscience, The University of Queensland, 306 Carmody Road, Building 80, St Lucia, QLD, 4072, Australia
| |
Collapse
|
19
|
Foster L, Robson SJ, Yazdani A, O'Shaughnessy PY. Changes in the incidence and uptake of reproductive surgery versus in vitro fertilisation in Australia between 2001 and 2015: A population-based study. Aust N Z J Obstet Gynaecol 2018; 59:272-278. [PMID: 30485412 DOI: 10.1111/ajo.12926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 10/18/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Improvements in success rates of assisted reproduction led to predictions that infertility surgery in both women and men would become extinct in developed countries. We sought to identify the changes in reproductive surgery that occurred between 2001 and 2015 to determine whether these predictions have been accurate. DESIGN The Australian Institute of Health and Welfare (AIHW) national procedural dataset and the Australian Medicare Benefits Scheme (MBS) claims database were searched for procedure data for male and female reproductive surgery and assisted reproduction from January 2001 to December 2015. The denominators were based on annual point estimates of the total population aged 25-44 years (female) and 25-55 years (male) from the Australian Bureau of Statistics (ABS). This dataset provides procedures undertaken but not their indications. RESULTS Over the study period the incidence of tubal surgery fell by 66%, vasectomy reversal by 33%, and surgical varicocoelectomy by 50%. In contrast, the rate of hysteroscopic myomectomy increased by 48%, hysteroscopic septoplasty by 125%, and laparoscopy for severe endometriosis increased by 84%. In vitro fertilisation oocyte retrievals increased by 90%. The rate of abdominal myomectomy was unchanged. CONCLUSION Fertility surgery is not dead but has evolved.
Collapse
Affiliation(s)
- Leon Foster
- Centenary Hospital for Women and Children, Canberra, Australian Capital Territory, Australia
| | - Stephen J Robson
- Australian National University, Canberra, Australian Capital Territory, Australia
| | - Anusch Yazdani
- The University of Queensland, Brisbane, Queensland, Australia
| | - Pauline Y O'Shaughnessy
- School of Mathematics and Applied Statistics, The University of Wollongong, Wollongong, New South Wales, Australia
| |
Collapse
|
20
|
Wang X, Li X, Wang T, Wu SP, Jeong JW, Kim TH, Young SL, Lessey BA, Lanz RB, Lydon JP, DeMayo FJ. SOX17 regulates uterine epithelial-stromal cross-talk acting via a distal enhancer upstream of Ihh. Nat Commun 2018; 9:4421. [PMID: 30356064 PMCID: PMC6200785 DOI: 10.1038/s41467-018-06652-w] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/31/2018] [Indexed: 02/07/2023] Open
Abstract
Mammalian pregnancy depends on the ability of the uterus to support embryo implantation. Previous studies reveal the Sox17 gene as a downstream target of the Pgr-Gata2-dependent transcription network that directs genomic actions in the uterine endometrium receptive for embryo implantation. Here, we report that ablating Sox17 in the uterine epithelium impairs leukemia inhibitory factor (LIF) and Indian hedgehog homolog (IHH) signaling, leading to failure of embryo implantation. In vivo deletion of the SOX17-binding region 19 kb upstream of the Ihh locus by CRISPR-Cas technology reduces Ihh expression specifically in the uterus and alters proper endometrial epithelial-stromal interactions, thereby impairing pregnancy. This SOX17-binding interval is also bound by GATA2, FOXA2, and PGR. This cluster of transcription factor binding is common in 737 uterine genes and may represent a key regulatory element essential for uterine epithelial gene expression.
Collapse
Affiliation(s)
- Xiaoqiu Wang
- Reproductive and Development Biology Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
- Department of Animal Science, North Carolina State University, Raleigh, NC, USA
| | - Xilong Li
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
- Feed Research Institute, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Tianyuan Wang
- Integrative Bioinformatics Support Group, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - San-Pin Wu
- Reproductive and Development Biology Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Jae-Wook Jeong
- Department of Obstetrics and Gynecology and Reproductive Biology, Michigan State University, Grand Rapids, MI, USA
| | - Tae Hoon Kim
- Department of Obstetrics and Gynecology and Reproductive Biology, Michigan State University, Grand Rapids, MI, USA
| | - Steven L Young
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA
| | - Bruce A Lessey
- Deptartment of Obstetrics and Gynecology, University of South Carolina School of Medicine, Greenville, SC, USA
| | - Rainer B Lanz
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - John P Lydon
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - Francesco J DeMayo
- Reproductive and Development Biology Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
| |
Collapse
|
21
|
Bastu E, Demiral I, Gunel T, Ulgen E, Gumusoglu E, Hosseini MK, Sezerman U, Buyru F, Yeh J. Potential Marker Pathways in the Endometrium That May Cause Recurrent Implantation Failure. Reprod Sci 2018; 26:879-890. [PMID: 30081718 DOI: 10.1177/1933719118792104] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The aim of this prospective cohort study was to identify altered biologic processes in the endometrium that may be potential markers of receptive endometrium in patients with repeated implantation failure (RIF) as compared with fertile controls. The study was conducted in a university-affiliated in vitro fertilization (IVF) gynecology clinic and molecular biology and genetics laboratory. Healthy fertile controls (n = 24) and patients with RIF (n = 24) were recruited. Window of implantation gene profiling associated with RIF was performed. Six hundred forty-one differentially expressed genes were identified, and 44 pathways were found enriched. Upon clustering of the enriched pathways, 9 representative pathways were established. The important pathways that were identified included circadian rhythm, pathways in cancer, proteasome, complement and coagulation cascades, citrate cycle, adherens junction, immune system and inflammation, cell cycle, and renin-angiotensin system. The involvement of the circadian rhythm pathway and other related pathways may alter the endometrium's functioning to ultimately cause RIF. Furthermore, we found that the pathogenesis of RIF was multifaceted and that numerous processes were involved. We believe that a better understanding of the underlying mechanisms of RIF will ultimately give rise to better treatment opportunities and to better outcomes in IVF.
Collapse
Affiliation(s)
- Ercan Bastu
- Department of Obstetrics and Gynecology, Acibadem University School of Medicine, Ataşehir, Istanbul, Turkey.
| | - Irem Demiral
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard University, Boston, MA, USA
| | - Tuba Gunel
- Department of Molecular Biology and Genetics, Istanbul University, Istanbul, Turkey
| | - Ege Ulgen
- Department of Biostatistics and Medical Informatics, Acibadem University School of Medicine, Istanbul, Turkey
| | - Ece Gumusoglu
- Department of Molecular Biology and Genetics, Istanbul University, Istanbul, Turkey
| | | | - Ugur Sezerman
- Department of Biostatistics and Medical Informatics, Acibadem University School of Medicine, Istanbul, Turkey
| | - Faruk Buyru
- Department of Obstetrics and Gynecology, Acibadem University School of Medicine, Ataşehir, Istanbul, Turkey
| | - John Yeh
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard University, Boston, MA, USA
| |
Collapse
|
22
|
Rahimipour M, Salehnia M, Jafarabadi M. Morphological, Ultrastructural, and Molecular Aspects of In Vitro Mouse Embryo Implantation on Human Endometrial Mesenchymal Stromal Cells in The Presence of Steroid Hormones as An Implantation Model. CELL JOURNAL 2018; 20:369-376. [PMID: 29845791 PMCID: PMC6004996 DOI: 10.22074/cellj.2018.5221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 10/08/2017] [Indexed: 12/04/2022]
Abstract
Objective This experimental study aimed to evaluate the effects of 17β-estradiol (E2) and progesterone (P4) on the interaction
between mouse embryo and human endometrial mesenchymal stromal cells, and gene expressions related to implantation
[αV and β3 integrins, interleukin-1 receptor (IL-1R), and leukemia inhibitory factor receptor (LIFR)] using an in vitro two-
dimensional model.
Materials and Methods In this experimental study, the endometrial stromal cells were isolated enzymatically and
mechanically, and cultured to the fourth passage. Next, their immunophenotype was confirmed by flow cytometric
analysis as mesenchymal stromal cells. The cells were cultured as either the experimental group in the presence of E2
(0.3 nmol) and P4 (63.5 nmol) or control group without any hormone treatment. Mouse blastocysts were co-cultured
with endometrial mesenchymal stromal cells in both groups for 48 hours. Their interaction was assessed under an
inverted microscope and scanning electron microscopy (SEM). Expressions of αV and β3 integrins, LIFR, and IL-1R
genes were analyzed by real-time reverse transcription-polymerase chain reaction (RT-PCR).
Results Similar observations were seen in both groups by light microscopy and SEM. We observed the presence of
pinopode-like structures and cell secretions on the apical surfaces of endometrial mesenchymal stromal cells in both
groups. The trophoblastic cells expanded and interacted with the mesenchymal monolayer cells. At the molecular
level, expression of IL-1R significantly increased in the hormonal treated group compared to the control (P≤0.05).
Expressions of the other genes did not differ.
Conclusion This study has shown that co-culture of endometrial mesenchymal stromal cells with mouse embryo in
media that contained E2 (0.3 nmol) and P4 (63.5 nmol) could effectively increase the expression of IL-1R, which is
involved in embryo implantation. However, there were no significant effects on expressions of αV and β3 integrins,
LIFR, and on the morphology and ultrastructure of endometrial mesenchymal stromal cells.
Collapse
Affiliation(s)
- Marzieh Rahimipour
- Department of Anatomy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mojdeh Salehnia
- Department of Anatomy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mina Jafarabadi
- Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic Address:
| |
Collapse
|
23
|
Parks JC, McCallie BR, Patton AL, Al-Safi ZA, Polotsky AJ, Griffin DK, Schoolcraft WB, Katz-Jaffe MG. The impact of infertility diagnosis on embryo-endometrial dialogue. Reproduction 2018; 155:543-552. [PMID: 29636406 DOI: 10.1530/rep-17-0566] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 04/10/2018] [Indexed: 12/24/2022]
Abstract
Initial stages of implantation involve bi-directional molecular crosstalk between the blastocyst and endometrium. This study investigated an association between infertility etiologies, specifically advanced maternal age (AMA) and endometriosis, on the embryo-endometrial molecular dialogue prior to implantation. Co-culture experiments were performed with endometrial epithelial cells (EEC) and cryopreserved day 5 blastocysts (n = 41 ≥ Grade 3BB) donated from patients presenting with AMA or endometriosis, compared to fertile donor oocyte controls. Extracellular vesicles isolated from co-culture supernatant were analyzed for miRNA expression and revealed significant alterations correlating to AMA or endometriosis. Specifically, AMA resulted in 16 miRNAs with increased expression (P ≤ 0.05) and strong evidence for negative regulation toward 206 target genes. VEGFA, a known activator of cell adhesion, displayed decreased expression (P ≤ 0.05), validating negative regulation by 4 of these increased miRNAs: miR-126; 150; 29a; 29b (P ≤ 0.05). In endometriosis patients, a total of 10 significantly altered miRNAs displayed increased expression compared to controls (miR-7b; 9; 24; 34b; 106a; 191; 200b; 200c; 342-3p; 484) (P ≤ 0.05), targeting 1014 strong evidence-based genes. Three target genes of miR-106a (CDKN1A, E2F1 and RUNX1) were independently validated. Functional annotation analysis of miRNA-target genes revealed enriched pathways for both infertility etiologies, including disrupted cell cycle regulation and proliferation (P ≤ 0.05). These extracellular vesicle-bound secreted miRNAs are key transcriptional regulators in embryo-endometrial dialogue and may be prospective biomarkers of implantation success. One of the limitations of this study is that it was a stimulated, in vitro model and therefore may not accurately reflect the in-vivo environment.
Collapse
Affiliation(s)
- Jason C Parks
- Colorado Center for Reproductive MedicineLone Tree, Colorado, USA .,University of KentCanterbury, UK
| | - Blair R McCallie
- Colorado Center for Reproductive MedicineLone Tree, Colorado, USA.,University of KentCanterbury, UK
| | - Alyssa L Patton
- Colorado Center for Reproductive MedicineLone Tree, Colorado, USA
| | - Zain A Al-Safi
- Department of Obstetrics and GynecologyUniversity of Colorado School of Medicine, Aurora, Colorado, USA
| | - Alex J Polotsky
- Department of Obstetrics and GynecologyUniversity of Colorado School of Medicine, Aurora, Colorado, USA
| | | | | | | |
Collapse
|
24
|
Evans GE, Phillipson GTM, Sykes PH, McNoe LA, Print CG, Evans JJ. Does the endometrial gene expression of fertile women vary within and between cycles? Hum Reprod 2018; 33:452-463. [DOI: 10.1093/humrep/dex385] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 12/26/2017] [Indexed: 12/24/2022] Open
Affiliation(s)
- Gloria E Evans
- Department of Obstetrics & Gynaecology, University of Otago, Christchurch, Christchurch Women’s Hospital, 2 Riccarton Avenue, Christchurch 8011, New Zealand
| | | | - Peter H Sykes
- Department of Obstetrics & Gynaecology, University of Otago, Christchurch, Christchurch Women’s Hospital, 2 Riccarton Avenue, Christchurch 8011, New Zealand
| | - Les A McNoe
- Otago Genomics and Bioinformatics Facility, Department of Biochemistry, University of Otago, 362 Leith Street, Dunedin 9016, New Zealand
| | - Cristin G Print
- Department of Molecular Medicine and Pathology and The Maurice Wilkins Centre, University of Auckland, 53 Park Road, Auckland 1023, New Zealand
| | - John J Evans
- Department of Obstetrics & Gynaecology, University of Otago, Christchurch, Christchurch Women’s Hospital, 2 Riccarton Avenue, Christchurch 8011, New Zealand
| |
Collapse
|
25
|
Chen Y, Ma L, Wang S. The impact of an increased progesterone-to-follicle number ratio on live delivery rates in women with normal ovarian reserve. Int J Gynaecol Obstet 2017; 139:84-89. [PMID: 28685817 DOI: 10.1002/ijgo.12256] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/18/2017] [Accepted: 07/03/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To explore the relationship between progesterone-follicle number (P/F) ratio and live delivery rate in patients with normal ovarian reserve undergoing cleavage-stage embryo transfer with a long gonadotropin-releasing hormone agonist cycle. METHODS The present retrospective study included data from patients younger than 38 years with normal ovarian reserve who were undergoing in vitro fertilization/intracytoplasmic sperm injection and embryo transfer at Zhongnan Hospital, Wuhan University, China, between January 1, 2009 and December 31, 2015. Patients underwent cleavage-stage fresh embryo transfer with a long gonadotropin-releasing hormone agonist cycle, and associations between P/F ratios and fertility/pregnancy outcomes were analyzed. RESULTS Patients with a P/F ratio of 0.11 or above had higher serum progesterone levels (P<0.001) and lower serum estradiol levels (P<0.001) on the day of human chorionic gonadotropin administration in comparison with patients with lower P/F ratios; elevated P/F ratios were also associated with fewer follicles at least 14 mm in size (P<0.001) and lower live delivery rates (P<0.001). Multiple logistic regression confirmed that P/F ratio was an independent predictor of live delivery rate (P=0.001). CONCLUSION A P/F ratio of at least 0.11 was associated with lower live delivery rates in women with normal ovarian reserve undergoing cleavage-stage embryo transfer with a long gonadotropin-releasing hormone agonist cycle.
Collapse
Affiliation(s)
- Ya Chen
- School of Public Health, Wuhan University, Wuhan, China.,China Three Gorges University, Yichang, China
| | - Ling Ma
- Reproductive Medicine Centre, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Suqing Wang
- School of Public Health, Wuhan University, Wuhan, China
| |
Collapse
|
26
|
Mamon MAC, Ramos GB. Maternal selenium-supplementation at various stages of periconception period: influence on murine blastocyst morphology and implantation status. JOURNAL OF ANIMAL SCIENCE AND TECHNOLOGY 2017; 59:7. [PMID: 28373910 PMCID: PMC5376488 DOI: 10.1186/s40781-017-0132-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 02/17/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Selenium is one of the trace minerals whose deficiency is known to lead to complications of female reproduction. The identified gaps in researches regarding selenium and pregnancy include optimizing the dosage of selenium supplementation, timing of supplementation, finding the best form and type of selenium, and selenium administration combined with other antioxidants. Hence, this study was conceptualized to address one of the identified gaps, that is, to find out the best timing of selenium administration around the time of pregnancy. Specifically, this study aimed to assess the effects of maternal Selenium-supplementation, administered at various stages of periconception period, on murine blastocyst morphology, percent occurrence of good quality blastocysts, and implantation status. METHODS ICR female mice were randomly assigned into the unsupplemented group (Group I) receiving basal diet without selenium, and treatment groups given with 3.0 μg selenium-supplement per day during pregestation only (Group II), pregestation-throughout-gestation (Group III) and gestation only (Group IV). Both blastocyst morphology and implantation status were assessed. RESULTS The morphometric measurements of blastocysts appeared to be unaffected by selenium-supplementation at different stages of periconception. Selenium-supplementation at pregestation only (Group II) and gestation only (Group IV) produced higher percent occurrence of good quality blastocysts and lower percent pre-implantation loss than Group III. Among all the treatment groups, Group III (Selenium-supplementation during pregestation-to-gestation) yielded the lowest quality blastocysts and highest percent pre-implantation loss. CONCLUSION Maternal selenium-supplementation during pregestation and gestation stages of the periconception period yielded a high percent occurrence of good quality blastocysts and pre-implantation success.
Collapse
Affiliation(s)
- Mark Anthony C. Mamon
- Biology Department, College of Science, De La Salle University, Taft Avenue, Manila, 1004 Philippines
| | - Gliceria B. Ramos
- Biology Department, College of Science, De La Salle University, Taft Avenue, Manila, 1004 Philippines
| |
Collapse
|
27
|
Herington JL, Guo Y, Reese J, Paria BC. Gene profiling the window of implantation: Microarray analyses from human and rodent models. ACTA ACUST UNITED AC 2016; 2:S19-S25. [PMID: 28239559 DOI: 10.1016/j.jrhm.2016.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Poor uterine receptivity leads to implantation defects or failure. Identification of uterine molecules crucial to uterine receptivity and/or embryo implantation provides the opportunity to design a diagnostic screening toolkit for uterine receptivity or targeted drug discovery for treating implantation-based infertility. In this regard, gene-profiling studies performed in humans and rodents have identified numerous genes involved in the transcriptional regulation of uterine receptivity and embryo implantation. In this article, we compared available uterine microarray datasets collected during the time of uterine receptivity and implantation in humans, mice and hamsters to uncover conserved gene sets. We also compared the transcriptome signature of women with unexplained infertility (UIF) and recurrent implantation failure (RIF) to gain insight into genes potentially dysregulated during endometrial receptivity or embryo implantation. Among numerous differentially expressed genes, few were revealed that might have molecular diagnostic screening potential for identifying the uterine receptive state during the time of implantation. Finally, functional annotation of gene sets uncovered altered uterine apoptosis or cell adhesion pathways in women with UIF and RIF, respectively. These conserved or divergent gene sets provide insights into the uterine receptive state for supporting blastocyst implantation.
Collapse
Affiliation(s)
- Jennifer L Herington
- Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Yan Guo
- Department of Cancer Biology and Vanderbilt Technologies for Advanced Genomics Analysis and Research Design, Vanderbilt University, Nashville, TN 37232, USA
| | - Jeff Reese
- Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Bibhash C Paria
- Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| |
Collapse
|
28
|
Integrative Analyses of Uterine Transcriptome and MicroRNAome Reveal Compromised LIF-STAT3 Signaling and Progesterone Response in the Endometrium of Patients with Recurrent/Repeated Implantation Failure (RIF). PLoS One 2016; 11:e0157696. [PMID: 27304912 PMCID: PMC4909214 DOI: 10.1371/journal.pone.0157696] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 06/02/2016] [Indexed: 12/23/2022] Open
Abstract
Intimate two-way interactions between the implantation-competent blastocyst and receptive uterus are prerequisite for successful embryo implantation. In humans, recurrent/repeated implantation failure (RIF) may occur due to altered uterine receptivity with aberrant gene expression in the endometrium as well as genetic defects in embryos. Several studies have been performed to understand dynamic changes of uterine transcriptome during menstrual cycles in humans. However, uterine transcriptome of the patients with RIF has not been clearly investigated yet. Here we show that several signaling pathways as well as many genes and microRNAs are dysregulated in the endometrium of patients with RIF (RIFE). Whereas unsupervised hierarchical clustering showed that overall mRNA and microRNA profiles of RIFE were similar to those of endometria of healthy women, many genes were significantly dysregulated in RIFE (cut off at 1.5 fold change). The majority (~75%) of differentially expressed genes in RIFE including S100 calcium binding protein P (S100P), Chemokine (C-X-C motif) ligand 13 (CXCL13) and SIX homeobox 1 (SIX1) were down-regulated, suggesting that reduced uterine expression of these genes is associated with RIF. Gene Set Enrichment analyses (GSEA) for mRNA microarrays revealed that various signaling pathways including Leukemia inhibitory factor (LIF) signaling and a P4 response were dysregulated in RIFE although expression levels of Estrogen receptor α (ERα) and Progesterone receptor (PR) were not significantly altered in RIFE. Furthermore, expression and phosphorylation of Signal transducer and activator of transcription 3 (STAT3) are reduced and a gene set associated with Janus kinase (JAK)-STAT signaling pathway is systemically down-regulated in these patients. Pairwise analyses of microRNA arrays with prediction of dysregulated microRNAs based on mRNA expression datasets demonstrated that 6 microRNAs are aberrantly regulated in RIFE. Collectively, we here suggest that dysregulation of several major signaling pathways and genes critical for uterine biology and embryo implantation may lead to uterine abnormalities in patients with RIF.
Collapse
|
29
|
Human Decidual Stromal Cells as a Component of the Implantation Niche and a Modulator of Maternal Immunity. J Pregnancy 2016; 2016:8689436. [PMID: 27239344 PMCID: PMC4864559 DOI: 10.1155/2016/8689436] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 02/26/2016] [Accepted: 03/27/2016] [Indexed: 12/27/2022] Open
Abstract
The human decidua is a specialized tissue characterized by embryo-receptive properties. It is formed during the secretory phase of menstrual cycle from uterine mucosa termed endometrium. The decidua is composed of glands, immune cells, blood and lymph vessels, and decidual stromal cells (DSCs). In the process of decidualization, which is controlled by oestrogen and progesterone, DSCs acquire specific functions related to recognition, selection, and acceptance of the allogeneic embryo, as well as to development of maternal immune tolerance. In this review we discuss the relationship between the decidualization of DSCs and pathological obstetrical and gynaecological conditions. Moreover, the critical influence of DSCs on local immune cells populations as well as their relationship to the onset and maintenance of immune tolerance is described.
Collapse
|
30
|
Altmäe S, Tamm-Rosenstein K, Esteban FJ, Simm J, Kolberg L, Peterson H, Metsis M, Haldre K, Horcajadas JA, Salumets A, Stavreus-Evers A. Endometrial transcriptome analysis indicates superiority of natural over artificial cycles in recurrent implantation failure patients undergoing frozen embryo transfer. Reprod Biomed Online 2016; 32:597-613. [PMID: 27090967 DOI: 10.1016/j.rbmo.2016.03.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 03/14/2016] [Accepted: 03/15/2016] [Indexed: 11/28/2022]
Abstract
Little consensus has been reached on the best protocol for endometrial preparation for frozen embryo transfer (FET). It is not known how, and to what extent, hormone supplementation in artificial cycles influences endometrial preparation for embryo implantation at a molecular level, especially in patients who have experienced recurrent implantation failure. Transcriptome analysis of 15 endometrial biopsy samples at the time of embryo implantation was used to compare two different endometrial preparation protocols, natural versus artificial cycles, for FET in women who have experienced recurrent implantation failure compared with fertile women. IPA and DAVID were used for functional analyses of differentially expressed genes. The TRANSFAC database was used to identify oestrogen and progesterone response elements upstream of differentially expressed genes. Cluster analysis demonstrated that natural cycles are associated with a better endometrial receptivity transcriptome than artificial cycles. Artificial cycles seemed to have a stronger negative effect on expression of genes and pathways crucial for endometrial receptivity, including ESR2, FSHR, LEP, and several interleukins and matrix metalloproteinases. Significant overrepresentation of oestrogen response elements among the genes with deteriorated expression in artificial cycles (P < 0.001) was found; progesterone response elements predominated in genes with amended expression with artificial cycles (P = 0.0052).
Collapse
Affiliation(s)
- Signe Altmäe
- Competence Centre on Health Technologies, Tartu, Estonia; Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain.
| | | | | | - Jaak Simm
- Department of Gene Technology, Tallinn University of Technology, Tallinn, Estonia
| | - Liis Kolberg
- Institute of Computer Science, University of Tartu, Estonia
| | - Hedi Peterson
- Institute of Computer Science, University of Tartu, Estonia; Quretec Ltd., Tartu, Estonia
| | - Madis Metsis
- Competence Centre on Health Technologies, Tartu, Estonia; School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Kai Haldre
- Centre for Reproductive Medicine, West Tallinn Central Hospital Women's Clinic, Tallinn, Estonia
| | | | - Andres Salumets
- Competence Centre on Health Technologies, Tartu, Estonia; Department of Obstetrics and Gynaecology, University of Tartu, Tartu, Estonia
| | | |
Collapse
|
31
|
Palomba S, Santagni S, La Sala GB. Progesterone administration for luteal phase deficiency in human reproduction: an old or new issue? J Ovarian Res 2015; 8:77. [PMID: 26585269 PMCID: PMC4653859 DOI: 10.1186/s13048-015-0205-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Accepted: 11/11/2015] [Indexed: 12/25/2022] Open
Abstract
Luteal phase deficiency (LPD) is described as a condition of insufficient progesterone exposure to maintain a regular secretory endometrium and allow for normal embryo implantation and growth. Recently, scientific focus is turning to understand the physiology of implantation, in particular the several molecular markers of endometrial competence, through the recent transcriptomic approaches and microarray technology. In spite of the wide availability of clinical and instrumental methods for assessing endometrial competence, reproducible and reliable diagnostic tests for LPD are currently lacking, so no type-IA evidence has been proposed by the main scientific societies for assessing endometrial competence in infertile couples. Nevertheless, LPD is a very common condition that may occur during a series of clinical conditions, and during controlled ovarian stimulation (COS) and hyperstimulation (COH) programs. In many cases, the correct approach to treat LPD is the identification and correction of any underlying condition while, in case of no underlying dysfunction, the treatment becomes empiric. To date, no direct data is available regarding the efficacy of luteal phase support for improving fertility in spontaneous cycles or in non-gonadotropin induced ovulatory cycles. On the contrary, in gonadotropin in vitro fertilization (IVF) and non-IVF cycles, LPD is always present and progesterone exerts a significant positive effect on reproductive outcomes. The scientific debate still remains open regarding progesterone administration protocols, specially on routes of administration, dose and timing and the potential association with other drugs, and further research is still needed.
Collapse
Affiliation(s)
- Stefano Palomba
- Centre of Reproductive Medicine and Surgery, Arcispedale Santa Maria Nuova - IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy.
| | - Susanna Santagni
- Centre of Reproductive Medicine and Surgery, Arcispedale Santa Maria Nuova - IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy.
| | - Giovanni Battista La Sala
- Centre of Reproductive Medicine and Surgery, Arcispedale Santa Maria Nuova - IRCCS, University of Modena and Reggio Emilia, Via Università 4, 41100 Viale Risorgimento 80, 42123, Modena, Italy.
| |
Collapse
|
32
|
Regidor PA. Progesterone in Peri- and Postmenopause: A Review. Geburtshilfe Frauenheilkd 2014; 74:995-1002. [PMID: 25484373 DOI: 10.1055/s-0034-1383297] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 10/01/2014] [Accepted: 10/01/2014] [Indexed: 01/26/2023] Open
Abstract
Around 14.5 million peri- and postmenopausal women currently live in Germany. Moreover, approximately 450 000 women, each with a life expectancy of around 85 years, reach menopause every year in Germany. The challenge is therefore to find a therapy with few side effects which could improve the quality of life of women with menopausal symptoms. The aim of hormone therapy (HT) is to remedy hormone deficiencies using substances that offer the best trade-off between benefits and risks. This is where progesterone has a new and important role to play. Progesterone is one of the most important gestagens. Biologically effective progesterone formulations created with micronization techniques have been used in clinical practice since 1996. Nevertheless, up until 2003 preference was given to synthetic gestagens rather than progesterone. The increased breast cancer hazard ratio of 1.23 reported in the WHI study and of 2 given in the Million Women Study has been associated with the use of synthetic gestagens. In a comparison between synthetic gestagens and progesterone, the E3N Study showed that the transdermal administration of estrogen and progesterone did not lead to an increase in breast cancer rates (RR: 1.08). The administration of progesterone does not change the HDL/LDL cholesterol ratio. Because of its anti-mineralocorticoid effect, progesterone has no impact on carbohydrate metabolism, hemostasis, blood pressure, thrombogenicity and body weight. The administration of 200 mg/day progesterone over 12 days of a menstrual cycle or a daily administration of 100 mg combined with an estrogen are a safe and well-tolerated option to treat menopausal symptoms, with a better benefit risk profile compared to synthetic gestagens.
Collapse
Affiliation(s)
- P-A Regidor
- Praxis für Frauenheilkunde, München ; Velvian GmbH, Ismaning
| |
Collapse
|