Evaluation Of Endometrial Receptivity In Patients With Recurrent Pregnancy Losses And Recurrent Implantation Failures With Assisted Reproductive Technologies: An Immunohistochemical Study

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Thesis Type: Expertise In Medicine

Institution Of The Thesis: Gazi University, Tıp Fakültesi, Cerrahi Tıp Bilimleri, Turkey

Approval Date: 2020

Thesis Language: Turkish

Student: SULTAN CANAN

Supervisor: AHMET ERDEM

Open Archive Collection: AVESIS Open Access Collection

Abstract:

For a successful implantation, a live blastocyst must attach a receptive endometrium in the appropriate time. It has been shown that recurrent implantation failure and recurrent pregnancy loss may be due to the pathologies of the endometrium, such as chronic endometritis, endometrial polyp. In addition, several cell adhesion molecules, extracellular matrix proteins and other molecules are responsible for the succesful attachment, implantation and early development of the conception and these molecules have shown to be expressed differently be in receptive endometrium as well as in other uterine pathologies. In this study, HOXA-11, β1 Integrin, FAK, CD44 and ECM1 staining were investigated in the biopsy materials taken in the receptive period of the endometrium from patients with recurrent implantation failure and recurrent pregnancy loss. Increased endometrial FAK staining was detected in patients with recurrent implantation failure. This increase suggested that the increase in the barrier function of the endometrium plays a role in the pathophysiology of the disease. A decrease in CD44 and ECM1 expression was detected. Accordingly, it was concluded that there may be a defect in the attachment of the embryo to the endometrium and vascular invasion. No change in the expression of HOXA-11 was detected. In patients with recurrent pregnancy loss, a reduction in β1 Integrin staining was detected. It was concluded that this decrease may be related to the superfertility, which is thought to play a role in the pathophysiology of RPL. A reduction in CD44 staining was detected, which was thought to be related to the defect in the vascular invasion of the embryo and placentation. No change was detected in the expression of HOXA-11, FAK and ECM1. This study shed light on changes in endometrial receptivity in patients with recurrent implantation failure and recurrent pregnancy loss, and more studies are needed to understand physiopathology in these patient groups.