Abstract:
This study was designed to investigate whether endometrial receptivity genes are altered in infertile patients with intramural
leiomyomas (IM) not distorting the endometrial cavity undergoing myomectomy. We measured endometrial HOXA-10,
HOXA-11, LIF, ITGB3, and ITGAV messenger RNA (mRNA) expressions levels before and after myomectomy/metroplasty
during mid-luteal phase in participants with IM, submucosal leiomyomas (SM), and septate uterus and fertile participants without
fibroids. Initial endometrial sampling was obtained at the time of surgery, and second sampling was obtained 3 months after
myomectomy/metroplasty. Expressions of each gene were evaluated using real-time reverse transcriptase polymerase chain
reaction (RT-PCR). A trend toward decreased endometrial HOXA-10, HOXA-11, and ITGAV mRNA expression was detected
in both SM and IM groups before myomectomy when compared to both fertile group and septate uterus. However, the differences
failed to show statistical significance. After myomectomy of IM, we have detected 12.8-fold increase in endometrial
HOXA-10 mRNA expression and 9.0-fold increase in endometrial HOXA-11 mRNA expression. This increase in endometrial
HOXA-10 and 11 mRNA expression was significant. Accordingly, 2 patients having intramural fibroids greater than 5 cm were
able to remain pregnant after myomectomy. Conversely, submucosal myomectomy did not cause any significant effect on
endometrial receptivity markers. Likewise, all markers of endometrial receptivity remained unchanged after metroplasty. Myomectomy
of IM have favorable effect on endometrial HOXA-10 and 11 mRNA expression.
