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Fertil Steril. 2010 Nov;94(6):2030-6. doi: 10.1016/j.fertnstert.2010.02.022. Epub 2010 Mar 24.

Local injury of the endometrium induces an inflammatory response that promotes successful implantation.

Author information

1
Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel.

Abstract

OBJECTIVE:

To study whether an injury-induced inflammation might be the mechanism underlying the favorable effect of endometrial biopsy on the implantation rate in in vitro fertilization (IVF) patients.

DESIGN:

Controlled clinical study.

SETTING:

A medical center IVF unit and a research institute.

PATIENT(S):

Women undergoing IVF who had previous failed treatment cycles.

INTERVENTION(S):

Endometrial samples were collected from two groups of patients on day 21 of their spontaneous menstrual cycle. The experimental, but not the control group underwent prior biopsy treatment on days 8 or/and 11 to 13 of that same cycle.

MAIN OUTCOME MEASURE(S):

Abundance of immune cells, cytokines/chemokines level, correlation between these parameters and pregnancy outcome.

RESULT(S):

A statistically significantly higher amount of macrophages/dendritic cells (HLA-DR+ CD11c+ cells) and elevated proinflammatory cytokines, tumor necrosis factor-α (TNF-α), growth-regulated oncogene-α (GRO-α), interleukin-15 (IL-15), and macrophage inflammatory protein 1B (MIP-1B), were detected in day-21 endometrial samples of the experimental group. A direct stimulatory effect of TNF-α on MIP-1B, GRO-α, and IL-15 messenger RNA (mRNA) expression was demonstrated. A positive correlation was found between the levels of macrophages/dendritic cells, MIP-1B expression, and TNF-α expression and the pregnancy outcome.

CONCLUSION(S):

A biopsy-induced inflammatory response may facilitate the preparation of the endometrium for implantation. Increased MIP-1B expression could possibly serve for prediction of implantation competence.

PMID:
20338560
PMCID:
PMC3025806
DOI:
10.1016/j.fertnstert.2010.02.022
[Indexed for MEDLINE]
Free PMC Article

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