Objectives : To evaluate the expression of Alpha V Beta 3 inlegrin (ccVpo) in infertile women with endometriosis in the
midluteal in-phase endometrial biopsies.
Design: Prospective controlled study.
Setting: Department of Obstetrics and Gynaecology, Shatby University Hospital and Department of Pathology.
Alexandria University.
Subjects: Twenty five infertile females having stage I or II endometriosis (group I) and twenty fertile controls (group
II).
Interventions: Midluteal endometrial biopsies by suction pipette were earned out during the implantation window.
Immunohistochemical staining for the expression of aVP3 integrins and progesterone receptors (PR) in endometrial
samples were performed. Serum levels of estradiol and progesterone were measured at the same day of endometrial
biopsy.
Main outcome measures: aVf33 inlegrin was significantly reduced (p=0.001) in infertile patients with endometriosis
(44%) compared to fertile controls (80%). Patients in group (I) had a statistically significant reduction (p=0.001) in the
overall mean intensity score compared to women in group (II) (0.52+0.65vs 2.011.21). The expression of ocV[j3 was
mainly glandular in both groups. However, in patients with positive inlegrin expression, the percentage of glandular
expression as well as the mean intensity score was significantly reduced in group (I) compared to group (II) (p=0.001,
p=0.0001 respectively). Hormonal levels were comparable between groups. The epithelial PRs were down regulated in
all in-phase endometrial samples in both groups. Integrin expression was inversely correlated with epithelial PRs in the
control group (r= - 0.89, p=0.001) but no correlation was found in the endometriosis group (r=0.14, p = 0.39).
Conclusion: aV|33 integrin expression is reduced during the window of implantation in infertile patients with stage I or
II endometriosis denoting that defective uterine receptivity might be an unrecognized cause of associdated infertility in
those women,