HOXA-10 and E-cadherin expression in the endometrium of women with recurrent implantation failure and recurrent miscarriage

Abstract

Objective: To compare the expression of HOXA-10 and E-cadherin in the endometrium of women with recurrent implantation failure (RIF), women with recurrent miscarriage (RM), and women with proven fertility (normal control; NC).

Design: Observational cohort study.

Setting: University assisted reproductive unit.

Patient(s): Fifty women were recruited: 18 NC, 12 unexplained RIF, and 20 RM.

Interventions(s): None.

Main outcome measure(s): Endometrial biopsy was precisely timed 7 days after LH surge. The expression of HOXA-10 and E-cadherin were examined by means of immunohistochemistry. H-Scores of staining intensity in the glandular epithelium and stroma were measured.

Result(s): HOXA-10 signal was mainly localized in the nuclei of stroma cells and the cytoplasm of glandular epithelium cells. E-Cadherin signal was found only in the cytoplasm of glandular epithelium cells. The HOXA-10 H-scores in the RIF group and the RM group were significantly lower than in the control group in both the glandular epithelium and stroma. The E-cadherin H-scores in the RM group were also significantly lower than in the control group. Interestingly, there was a positive correlation between HOXA-10 and E-cadherin H-scores in all of the women examined.

Conclusion(s): There is a positive correlation between levels of HOXA-10 and E-cadherin expression in the endometrium, both of which are significantly reduced in women with RIF and RM compared with fertile control women. The findings suggest a potential role of HOXA-10 and E-cadherin in the implantation processes and altered expression in women with reproductive failure.

Keywords: E-cadherin; HOXA-10; Recurrent implantation failure; recurrent miscarriage.