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Large, Non-Cavity Distorting Intramural Leiomyomas Decrease Leukemia Inhibitory Factor in the Secretory Phase

Bruce Pier1, Christopher Crellin2, Ashwini Katre3

  • 1Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Tripler Army Medical Center, Jarrett White Road, Honolulu, Hawaii, 96859, USA. bruce.d.pier3.mil@mail.mil.

Reproductive Sciences (Thousand Oaks, Calif.)
|February 13, 2020
PubMed
Summary
This summary is machine-generated.

Large intramural leiomyomas (IM) may reduce fertility by decreasing leukemia inhibitory factor (LIF) in the uterine lining. This study found lower LIF levels in women with IM, suggesting a potential mechanism impacting implantation during IVF.

Keywords:
Intramural fibroidLeiomyomaLeukemia inhibitory factor

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Area of Science:

  • Reproductive Endocrinology
  • Gynecology
  • Infertility Research

Background:

  • Large intramural leiomyomas (IM) are linked to reduced fecundity in IVF cycles.
  • The precise mechanisms by which IM affect fertility remain incompletely understood.
  • Endometrial receptivity factors are crucial for successful embryo implantation.

Purpose of the Study:

  • To investigate the hypothesis that large IM decrease endometrial expression of implantation factors.
  • To compare the expression of key implantation markers between women with and without IM.

Main Methods:

  • Prospective study involving sub-fertile patients with IM (≥3 cm) and controls.
  • Endometrial biopsies collected during the mid-secretory phase.
  • Quantitative immunohistochemistry used to assess expression of HOXA10, leukemia inhibitory factor (LIF), ER-α, and PR.

Main Results:

  • Patients with IM showed significantly decreased LIF expression compared to controls (p < 0.001).
  • HOXA10 and progesterone receptor (PR) expression did not differ between groups.
  • Estrogen receptor-alpha (ER-α) showed a trend toward increased expression in the IM cohort (p = 0.07).

Conclusions:

  • Large intramural leiomyomas are associated with downregulated LIF expression in the endometrium.
  • Decreased LIF may represent a novel mechanism contributing to reduced fecundity in women with IM.
  • Further research is warranted to determine if leiomyoma resection corrects LIF downregulation.