Hydrosalpinges adversely affect markers of endometrial receptivity

While in-vitro fertilization (IVF) was initially developed in women with tubal factor infertility, recent clinical studies have suggested that the presence of hydrosalpinges lowers implantation and pregnancy rates, We postulated that these hydrosalpinges cause impaired endometrial receptivity, A total of 103 women with hydrosalpinges were prospectively evaluated, and compared with 55 infertile and 44 fertile controls. All women had endometrial biopsies during the window of implantation, analysed by conventional histological criteria, and also stained for three integrin markers of endometrial receptivity (alpha 1 beta 1, alpha 4 beta 1 and alpha v beta 3), women with hydrosalpinges (cases) expressed significantly less of the alpha v beta 3 integrin compared with controls, There was no difference in expression of alpha 1 beta 1 or alpha 4 beta 1 among groups, A significantly greater number of cases had out of phase histology and missing alpha 1 beta 3 (type I defects) and absent integrin expression despite normal histological maturation (type II) defects, compared with controls, Of 20 women with impaired endometrial receptivity who were also biopsied after hydrosalpinx surgery, 70% demonstrated increased alpha v beta 3 expression, Seventy-seven percent of type I and 57% of type II defects were corrected postoperatively, Using markers of endometrial receptivity, this study demonstrates that inflammatory hydrosalpinges have an adverse effect on endometrial receptivity, which in some cases may be overcome by surgical treatment of the hydrosalpinx.