Premature expression of the decidualization marker prolactin is associated with repeated implantation failure

Abstract

Repeated implantation failure (RIF) is a poorly understood reproductive pathology defined by the inability to achieve a clinical pregnancy in at least three consecutive IVF cycles. In this study, we investigated whether the onset of decidualization, marked by prolactin (PRL) expression, is associated with RIF. We performed a retrospective cohort study using endometrial biopsies from women with idiopathic subfertility, that conceived naturally during the same cycle in which the biopsy was taken (group 1; n = 15) conceived naturally within three months after the biopsy was taken (group 2; n = 20), or unsuccessfully underwent six IUI cycles and three IVF cycles with transfer of at least one high-quality embryo (group 3, RIF; n = 20). Our results demonstrated that immunohistochemical PRL-staining was present in 8/15 women from group 1 (53.3%), in 1/20 women from group 2 (5.0%), and in 11/20 women from group 3 (55.0%). Increased proliferation, analyzed by Ki67 expression, was seen in women that were pregnant during the biopsy, compared to all women combined that were not pregnant (p≤.01). In conclusion, our study demonstrates that premature expression of the decidualization marker PRL during the luteal phase is associated with RIF.

摘要

反复种植失败（RIF）是一种了解甚少的生殖病理学, 其定义是在至少3个连续IVF周期中无法临床妊娠。在本研究中我们调查以催乳素（PRL）表达为标志物的蜕膜化是否与RIF相关。我们进行了一项回顾性队列研究, 纳入采用子宫内膜活检的特发性不孕女性, 活检同一周期自然受孕的（组1, n = 15）, 活检后3个月内自然受孕的（组2, n = 20）, 进行6个周期宫腔内人工授精（IUI）和3个IVF周期并种植了至少一个高质量胚胎后未成功受孕的（组3, RIF, n = 20）。我们的结果表明, 免疫组化PRL染色存在于组1中8/15（53.3％）女性, 组2中1/20（5.0％）女性和组3中11/20（55.0％）女性。与所有内膜活检周期内未怀孕的女性相比, 怀孕女性的子宫内膜中观察到Ki67增殖指标表达增加（p≤0.01）。总之, 本研究表明黄体期蜕膜化标志物PRL的过早表达与RIF有关。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Decidualization
• prolactin
• endometrium
• repeated implantation failure

Disclosure statement

The authors have no conflicts of interest to declare.