Endometrial integrin expression in women undergoing in vitro fertilization and the association with subsequent treatment outcome

Objective To study the endometrial expression of three integrins (αvβ3, α4β1, and α1β1) in women undergoing IVF–intracytoplasmic sperm injection (ICSI) treatment and assess whether they could be used to predict subsequent treatment success. Design Prospective observational study. Setting Healthy volunteers in a large teaching hospital. Patient(s) Sixty-six patients attending for IVF-ICSI treatment. Intervention(s) Timed endometrial biopsies were taken, during the implantation window at LH + 7–9 days, from women before IVF-ICSI treatment. Main outcome measure(s) Histological dating of endometrium and immunohistochemical staining intensity of α4β1, αvβ3, and α1β1 integrins. The integrin levels were correlated with subsequent success rates. Result(s) There was a statistically significantly greater expression of αvβ3 in the luminal epithelium of those patients who had successful treatment. However, treatment was successful in some patients with negative expression. Conclusion(s) Integrins are important markers of endometrial receptivity. There is an association between an in-phase endometrial biopsy, with positive luminal αvβ3 integrin expression, and subsequent treatment success. However, the clinical value of assessing the endometrium before treatment has drawbacks, and further work needs to be done before this can be considered a clinically useful test.