Effect of myomectomy on endometrial glutathione peroxidase 3 [GPx3] and glycodelin mRNA expression at the time of the implantation window

In fertile women, glycodelin and glutathione peroxidase 3 [GPx3] genes expression rises during the luteal phase, with a peak occurring during the implantation window. The expression of these genes decreases in women with myomas. To determine whether myomectomy would reverse glycodelin and GPx3 expression, we evaluated the transcript levels of these genes in the endometrium of patients before and after myomectomy. Expression of glycodelin and GPx3 genes were examined prospectively during the midluteal phase in the endometrium obtained from infertile women with myoma [n = 12] before and three months after myomectomy. Endometrial expression of these genes was evaluated using quantitative real-time RT-PCR. Endometrial glycodelin mRNA expression levels [normalized to 18S rRNA expression] were increased significantly in endometrium of patients after myomectomy [P = 0.02]. GPx3 mRNA expression was increased insignificantly after myomectomy [P = 0.43]. The results showed that myomectomy increased endometrial glycodelin [significantly] and GPx3 [not significantly] gene expression after 3 months. Study at different times and detecting expression of these genes can reveal more details

Effect of intramural myomectomy on endometrial HOXA10 and HOXA11 mRNA expression at the time of implantation window

HOXA11 and HOXA10 are expressed in endometrium throughout the menstrual cycle and show a dramatic increase during the mid-luteal phase at the time of implantation. The expression of these genes is decreased in women with myomas. To determine whether myomectomy would reverse HOXA11 and HOXA10 expression, we evaluated the transcript levels of these genes in the endometria of patients before and after myomectomy. Expression of HOXA11 and HOXA10 were examined prospectively during the midluteal phase in endometrium obtained from infertile women [n=12] with myoma before and three months after myomectomy. Endometrial HOXA11 and HOXA10 expression were evaluated using quantitative real-time reverse transcriptase-polymerase chain reaction [RT-PCR]. Endometrial HOXA11 and HOXA10 mRNAs expression levels [normalized to 18SrRNA] were increased insignificantly in endometrium of patients after myomectomy [p=0.7 and p=0.15 respectively]. The results suggest that the alteration in expression pattern of these genes could not account for some aspects of fertility after myomectomy

[Semi-quantitative analysis of endometrial HOXA10 and BTEB1 mRNA expressions in the implantation window of patients with endometriosis and myoma]

The techniques used in assisted reproductive technologies have progressed considerably, but many embryos do not implant after transfer upon the use of these techniques. One of the causes of infertility is repeated implantation failure due to decreased endometrial receptivity. Furthermore, in clinical conditions such as endometriosis and myoma, implantation decreases after embryo transfer. In this case-control study the expression patterns of HOXA-10 and BTEB1 mRNAs were evaluated at the time of implantation in patients with myoma and endometriosis. In this study performed in Hamadan University of Medical Sciences during 1389, the cases included 16 patients with endometriosis and myoma [8 in each group] and the control group consisted of 8 fertile women. Endometrial sampling was performed at mid-secretory phase. Later, the expression patterns of HOXA-10 and BTEB1 mRNAs were evaluated using a semi-quantitative RT-PCR method. The optimal PCR cycles determined were 30, 32 and 26 for HOXA10, BTEB1 and beta-actin, respectively. Endometrial HOXA-10 and BTEB1 mRNA expression levels [normalized to beta-actin expression] at the time of implantation were significantly decreased in the endometrium of infertile patients with endometriosis compared with that of healthy fertile controls [P<0.05]. A similar pattern was seen in patients with myomas for both HOXA10 and BTEB1 genes, [P<0.05]. It seems that lower expression of HOXA-10 and BTEB1 mRNAs in the implantation window of endometrium that increase normally, could account for some aspects of infertility in patients with endometriosis and myoma

Metformin therapy decreases hyperandrogenism and ovarian volume in women with polycystic ovary syndrome

It is well known that there is a close relationship between elevated androgen plasma levels and the ultrasound findings of stromal hypertrophy in polycystic ovary syndrome [PCOS]. The objective of this study was to investigate the effects metformin on the hyperandrogenism and ovarian volume in PCOS. The study is an unrandomized clinical trial with before-after design. Twenty eight patients with infertility [male or female factor] meeting the Rotterdam ESHRE/ASRM criteria for PCOS were studied during the 2008-2009. The anthropometric characteristics of the patients, mean bilateral ovarian volume, and morphology by trans vaginal sonography as well as the plasma levels of leutinizing hormone, follicle stimulating hormone, estradiol, testosterone, 17- alpha -hydroxyprogesterone, and dehydroepianderosterone sulfate were obtained before and after treatment with metformin [500 mg three times a day] for three months. Paired t, Pearson's Correlation Coefficient, or Partial Correlation test was used to analyze the findings. The patients had a mean age of 25.67 years. A significant reduction in mean ovarian volume [11.70 +/- 4.31 ml vs 8.27 +/- 3.71 ml P=0.001], body mass index [BMI, 28.11 +/- 4.55 kg/m[2] vs 26.84 +/- 4.55 kg/m[2] P=0.000] and serum androgen levels was seen after three months of treatment with metformin. There was positive correlations between the ovarian volume and serum testosterone level [r=0.589, P=0.001] or BMI [r=0.663, P=0.000]. Metformin therapy may lead to a reduction in ovarian volume. It is likely that the reduction of ovarian volume reflect a decrease in the mass of androgen producing tissues

Semi-quantitative analysis of HOXA11, leukemia inhibitory factor and basic transcriptional element binding protein 1 mRNA expression in the mid-secretory endometrium of patients with endometriosis

HOXA11 and leukemia inhibitory factor [LIF] and basic transcriptional element binding protein1 [BTEB1] are expressed in endometrium throughout the menstrual cycle and show a dramatic increase during the mid-luteal phase at the time of implantation. In this case-control study, the expression pattern of these mRNA was evaluated in patients with endometriosis at the time of implantation. We also describe a semi-quantitative RT-PCR protocol optimized in our laboratory. Eight patients with endometriosis were considered as our case and 8 fertile women as control group. Expression levels of HOXA11, LIF and BTEB1 mRNA were measured in endometrium during the mid-secretory phase using semi-quantitative RT-PCR. We describe the detailed procedure for the analysis of HOXA11, LIF and BTEB1 mRNA levels. Endometrial HOXA11 and LIF mRNA expression levels [normalized to beta -actin expression] were significantly decreased in endometrium of infertile patients with endometriosis compared with healthy fertile controls at the time of implantation [P<0.05]. A similar trend was seen in BTEB1 mRNA expression. The results suggest that the alteration in expression pattern of the some genes could account for some aspects of infertility in endometriosis