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Fertil Steril. 2017 Mar;107(3):740-748.e2. doi: 10.1016/j.fertnstert.2016.11.009. Epub 2016 Dec 2.

Does an increased body mass index affect endometrial gene expression patterns in infertile patients? A functional genomics analysis.

Author information

1
Stanford University Clinic for Reproductive Medicine, Sunnyvale, California. Electronic address: yanna.comstock@gmail.com.
2
Valencia University/Instituto Valenciano de Infertilidad, Valencia, Spain.
3
Stanford University Clinic for Reproductive Medicine, Sunnyvale, California.
4
Baylor Family Fertility Center, Texas Children's Hospital Pavilion for Women, Houston, Texas.
5
Igenomix, Valencia, Spain.
6
Stanford University Clinic for Reproductive Medicine, Sunnyvale, California; Valencia University/Instituto Valenciano de Infertilidad, Valencia, Spain; Baylor Family Fertility Center, Texas Children's Hospital Pavilion for Women, Houston, Texas; Igenomix, Valencia, Spain.

Abstract

OBJECTIVE:

To analyze the transcriptomic profile of endometrial gene alterations during the window of implantation in infertile obese patients.

DESIGN:

Multicenter, prospective, case-control study.

SETTING:

Three academic medical centers for reproductive medicine.

PATIENT(S):

Infertile patients, stratified into body mass index (BMI) categories according to the World Health Organization guidelines, were included in the study.

INTERVENTION(S):

Endometrial samples were obtained from women undergoing standardized estrogen and P replacement cycles after 5 days of vaginal P supplementation.

MAIN OUTCOME MEASURE(S):

To identify endometrial gene expression alterations that occur during the window of implantation in infertile obese patients as compared with infertile normal-weight controls using a microarray analysis.

RESULT(S):

XCL1, XCL2, HMHA1, S100A1, KLRC1, COTL1, COL16A1, KRT7, and MFAP5 are significantly dysregulated during the window of implantation in the receptive endometrium of obese patients. COL16A1, COTL1, HMHA1, KRCL1, XCL1, and XCL2 were down-regulated and KRT7, MFAP5, and S100A1 were up-regulated in the endometrium of obese patients. These genes are mainly involved in chemokine, cytokine, and immune system activity and in the structural extracellular matrix and protein-binding molecular functions.

CONCLUSION(S):

Obesity is associated with significant endometrial transcriptomic differences as compared with non-obese subjects. Altered endometrial gene expression in obese patients may contribute to the lower implantation rates and increased miscarriage rates seen in obese infertile patients.

CLINICAL TRIAL REGISTRATION NUMBER:

NCT02205866.

KEYWORDS:

Endometrial gene expression; endometrial receptivity; infertility; metabolic syndrome; obesity

[Indexed for MEDLINE]

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