Evaluation of Endometrial Receptivity in Patients with Recurrent Pregnancy Loss and Recurrent Implantation Failure

Abstract

Abstract Background: The cause of implantation defects in patients with recurrent implantation failure (RIF) and recurrent pregnancy loss (RPL) has not been clearly established. We aimed to evaluate the immunohistochemical changes of HOXA-11, β1 integrin, Focal Adhesion Kinase (FAK), CD44, and Extracellular Matrix Protein 1 (ECM1) in the endometrium of patients with defective implantation -RIF and RPL- in the receptive period. Methods: This retrospective case-control study was conducted in a university hospital. After the exclusion of all cases with pathology that may cause a change in the level of receptors in the endometrium, biopsies taken during the receptive period were selected, and the patients were divided into RPL (n=15), RIF (n=16), and control (n=16) groups. All preparations were immunohistochemically stained for HOXA11, β1 integrin, FAK, CD44, and ECM1. The presence or absence of staining and staining intensity were compared between groups. Results: When the RIF group was compared with the control group, there was no significant difference in HOXA-11 and β1 Integrin expression (p>0.05), FAK expression was significantly increased compared to the control group (p<0.01); ECM1 and CD44 expressions were found to be significantly decreased (p<0.01). When the RPL group was compared with the control group, there was no significant difference in the endometrial staining of HOXA-11, FAK, and ECM1 in women with a history of RPL (p>0.05); β1 Integrin and CD44 levels were significantly decreased (p<0.05). Conclusion: CD44 reduction may play a role in pathophysiology in both patient groups. In addition, decreased β1 integrin may also play a role in RPL. In RIF, the increase in FAK and decrease in ECM1 seem to be involved in the mechanisms of the disease.