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Endometrial integrin expression in women exposed to diethylstilbestrol in utero
A J Castelbaum1, S W Sawin, L J Bellardo
1University of Pennsylvania Medical Center, Philadelphia, USA.
Objective:
To determine if the endometrium of women exposed in utero to diethylstilbestrol (DES) demonstrates altered integrin expression compared with normal fertile controls.
Design:
Case control study. Expression of eight integrins in 15 luteal phase endometrial biopsies from DES-exposed women were compared with 17 biopsies from age- and cycle day-matched controls. All patients were ovulatory. Endometrial biopsies were performed in the luteal phase, and all were histologically "in phase."
Setting:
Infertility practice of an academic teaching hospital.
Patients:
Women exposed in utero to DES and matched fertile controls.
Main Outcome Measures:
Intensity of endometrial integrin immunohistochemical staining by the semiquantitative HSCORE technique.
Results:
Endometrial stroma of DES-exposed women demonstrated greater expression of the integrin subunits alpha 5 and alpha v. No differences were noted between DES-exposed women and fertile controls in the glandular epithelial expression of integrin subunits alpha 1, alpha 2, alpha 3, alpha 6, and alpha v nor the stromal staining of subunits of alpha 6 and beta 3. Epithelial expression of integrin subunits beta 3 and alpha 4, reliable luteal markers of uterine receptivity, were similar in DES and control patients.
Conclusions:
Markers of uterine receptivity are similar in the endometrium of women exposed in utero to DES compared with normal fertile controls. Interesting differences exist in stromal integrin expression between groups, though the significance of this finding is uncertain at present. It is unlikely that DES-exposed women have significantly altered endometrial function as a cause of infertility.