Infertile women with isolated polycystic ovaries are deficient in endometrial expression of osteopontin but not alphavbeta3 integrin during the implantation window.

ABSTRACT

OBJECTIVE: To characterize possible endometrial defects in infertile women with isolated PCO morphology. DESIGN: Prospective study. SETTING: An academic hospital with an IVF unit. PATIENT(S) Women with primary unexplained infertility and isolated PCO, fertile women, and women with infertility secondary to male factor. INTERVENTION(S) Thirty-one women (fertile and with male factor infertility) had endometrial sampling across the menstrual cycle. Nine fertile women and 10 infertile women with isolated PCO had sampling on day LH +7, adjusted for histologic dating. MAIN OUTCOME MEASURE(S) Expression of alphavbeta3 and its ligand, osteopontin, were determined using real-time quantitative polymerase chain reaction and immunohistochemistry. In vitro regulation of osteopontin was assessed using the Ishikawa cell line. RESULT(S) Cyclic variations revealed a fall in integrin alphavbeta3 mRNA during the secretory phase with concomitant up-regulation of osteopontin mRNA. Immunohistochemistry on day LH +7 demonstrated a significant reduction in expression of osteopontin in the isolated PCO group with no difference in expression of alphavbeta3. In vitro studies confirmed up-regulation of osteopontin by estrogen with no apparent effect of androgen. CONCLUSION(S) These results demonstrate an apparent reduction of osteopontin expression, important in cell-cell adhesion, during the window of implantation in infertile women with isolated PCO morphology.