Laparoscopic Salpingectomy Regulates The Expression of Endometrial Homeobox Genes () and HOX Transcript Antisense Intergenic RNA in Women with Communicating Hydrosalpinx: A Prospective Study

Overview

Journal Int J Fertil Steril

Specialty Reproductive Medicine

Date 2024 Nov 20

PMID 39564825

Authors

Fatemeh Zafarani

Malek Soleimani Mehranjani

Firouzeh Ghaffari

Maryam Shahhoseini

Seyed Mohammadi Ali Shariatzadeh

Affiliations

Soon will be listed here.

Abstract

Background: This study aimed to determine the alteration of endometrial expression levels of genes and HOX transcript antisense intergenic RNA (HOTAIR) in mid-luteal phase endometrium in patients with hydrosalpinx before and after salpingectomy.

Materials And Methods: In this prospective study, 14 infertile women with unilateral hydrosalpinx who were scheduled for laparoscopic salpingectomy were evaluated. The presence of hydrosalpinx was confirmed by hysterosalpingography or transvaginal 2D-ultrasonography. All patients had normal hormonal profiles, body mass index, and regular menstrual cycles identified by mid-luteal serum progesterone. Fourteen healthy fertile age-matched women with a successful pregnancy history were considered the control group. Mid-luteal-phase endometrial biopsies were performed at the time of surgery and during the mid-luteal phase of the fourth treatment cycle by Pipelle. After tissue collection, RNA extraction and cDNA synthesis were performed. Real-time polymerase chain reaction (PCR) technique was used for quantitative gene expression of and lnc .

Results: The endometrial expression of (P<0.001), (P=0.001), (P=0.003), and (P=0.004) were significantly lower in the patients with hydrosalpinx compared to the controls. After salpingectomy, we observed a significant increase in the endometrial (P=0.006) and (P=0.023) mRNA expression levels compared to before salpingectomy samples. Similarly, a significant upregulation in endometrial (P= 0.013) and mRNA expression levels (P=0.012) were detected in postoperative samples compared to preoperative tissue. Moreover, the lnc HOTAIR was significantly higher in the endometrium-induced hydrosalpinx fluid than in controls (P=0.020), which had a 2.89-fold decrease following salpingectomy (P=0.010).

Conclusion: Elevated endometrial lncRNA HOTAIR may disrupt the expression of endometrial receptivity genes in women with hydrosalpinx. However, our results failed to show a significant inverse correlation between and HOX genes due to limited sample size. Further studies with larger sample sizes are required to investigate inverse co-expression with genes in these subjects.

References

Yang Y, Chen X, Saravelos S, Liu Y, Huang J, Zhang J . HOXA-10 and E-cadherin expression in the endometrium of women with recurrent implantation failure and recurrent miscarriage. Fertil Steril. 2016; 107(1):136-143.e2. DOI: 10.1016/j.fertnstert.2016.09.016. View

Rarani F, Borhani F, Rashidi B . Endometrial pinopode biomarkers: Molecules and microRNAs. J Cell Physiol. 2018; 233(12):9145-9158. DOI: 10.1002/jcp.26852. View

Pai P, Sukumar S . HOX genes and the NF-κB pathway: A convergence of developmental biology, inflammation and cancer biology. Biochim Biophys Acta Rev Cancer. 2020; 1874(2):188450. DOI: 10.1016/j.bbcan.2020.188450. View

Li L, Xu B, Chen Q, Sun X . Effects of hydrosalpinx on pinopodes, leukaemia inhibitory factor, integrin beta3 and MUC1 expression in the peri-implantation endometrium. Eur J Obstet Gynecol Reprod Biol. 2010; 151(2):171-5. DOI: 10.1016/j.ejogrb.2010.04.024. View

Zhong Y, Li J, Wu H, Ying Y, Liu Y, Zhou C . Surgical treatment for hydrosalpinx increases the expression of integrin αvβ3 in the endometrium during the implantation window. Exp Ther Med. 2012; 4(3):415-418. PMC: 3503799. DOI: 10.3892/etm.2012.610. View

Celik O, Celik E, Turkcuoglu I, Yilmaz E, Ulas M, Simsek Y . Surgical removal of endometrioma decreases the NF-kB1 (p50/105) and NF-kB p65 (Rel A) expression in the eutopic endometrium during the implantation window. Reprod Sci. 2012; 20(7):762-70. DOI: 10.1177/1933719112466307. View

Savaris R, Giudice L . The influence of hydrosalpinx on markers of endometrial receptivity. Semin Reprod Med. 2007; 25(6):476-82. DOI: 10.1055/s-2007-991045. View

Daftary G, Taylor H . Hydrosalpinx fluid diminishes endometrial cell HOXA10 expression. Fertil Steril. 2002; 78(3):577-80. DOI: 10.1016/s0015-0282(02)03306-x. View

Wang Q, Ai H, Li X, Tian H, Ning B, Zhang M . Association of miRNA-145 with the occurrence and prognosis of hydrosalpinx-induced defective endometrial receptivity. Bosn J Basic Med Sci. 2020; 21(1):81-92. PMC: 7861628. DOI: 10.17305/bjbms.2020.4538. View

10.

Wu Y, Halverson G, Basir Z, Strawn E, Yan P, Guo S . Aberrant methylation at HOXA10 may be responsible for its aberrant expression in the endometrium of patients with endometriosis. Am J Obstet Gynecol. 2005; 193(2):371-80. DOI: 10.1016/j.ajog.2005.01.034. View

11.

Gungor N, Onal M, Madenli A, Agar M . Surgical removal of FIGO type 0 and 1 fibroids ameliorates the expression of endometrial proinflammatory transcription factors and receptivity modulators. Fertil Steril. 2022; 119(3):504-513. DOI: 10.1016/j.fertnstert.2022.11.021. View

12.

Palagiano A, Cozzolino M, Ubaldi F, Palagiano C, Coccia M . Effects of Hydrosalpinx on Endometrial Implantation Failures: Evaluating Salpingectomy in Women Undergoing in vitro fertilization. Rev Bras Ginecol Obstet. 2021; 43(4):304-310. PMC: 10183881. DOI: 10.1055/s-0040-1722155. View

13.

Daftary G, Kayisli U, Seli E, Bukulmez O, Arici A, Taylor H . Salpingectomy increases peri-implantation endometrial HOXA10 expression in women with hydrosalpinx. Fertil Steril. 2006; 87(2):367-72. DOI: 10.1016/j.fertnstert.2006.06.041. View

14.

Capmas P, Suarthana E, Tulandi T . Management of Hydrosalpinx in the Era of Assisted Reproductive Technology: A Systematic Review and Meta-analysis. J Minim Invasive Gynecol. 2020; 28(3):418-441. DOI: 10.1016/j.jmig.2020.08.017. View

15.

Massimiani M, Lacconi V, La Civita F, Ticconi C, Rago R, Campagnolo L . Molecular Signaling Regulating Endometrium-Blastocyst Crosstalk. Int J Mol Sci. 2019; 21(1). PMC: 6981505. DOI: 10.3390/ijms21010023. View

16.

Unlu C, Celik O, Celik N, Otlu B . Expression of Endometrial Receptivity Genes Increase After Myomectomy of Intramural Leiomyomas not Distorting the Endometrial Cavity. Reprod Sci. 2015; 23(1):31-41. DOI: 10.1177/1933719115612929. View

17.

Schmitz S, Grote P, Herrmann B . Mechanisms of long noncoding RNA function in development and disease. Cell Mol Life Sci. 2016; 73(13):2491-509. PMC: 4894931. DOI: 10.1007/s00018-016-2174-5. View

18.

Cohen A, Almog B, Tulandi T . Hydrosalpinx Sclerotherapy Before In Vitro Fertilization: Systematic Review and Meta-analysis. J Minim Invasive Gynecol. 2017; 25(4):600-607. DOI: 10.1016/j.jmig.2017.12.004. View

19.

Demir M, Cam S . Hydrosalpingeal fluid leads to subfertility via endometrial TNF-α and IL-7 and NF-κB signaling pathways. Eur Rev Med Pharmacol Sci. 2023; 27(7):2980-2986. DOI: 10.26355/eurrev_202304_31930. View

20.

Noyes R, Hertig A, Rock J . Dating the endometrial biopsy. Am J Obstet Gynecol. 1975; 122(2):262-3. DOI: 10.1016/s0002-9378(16)33500-1. View