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

• Published in: Fertility and sterility Vol. 107; no. 3; pp. 740 - 748.e2
• Main Authors: Comstock, Ioanna A., Diaz-Gimeno, Patricia, Cabanillas, Sergio, Bellver, Jose, Sebastian-Leon, Patricia, Shah, Meera, Schutt, Amy, Valdes, Cecilia T., Ruiz-Alonso, Maria, Valbuena, Diana, Simon, Carlos, Lathi, Ruth B.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2017
• Subjects: Abortion, Spontaneous - genetics; Abortion, Spontaneous - physiopathology; Body Mass Index; California; Case-Control Studies; Embryo Implantation - genetics; Endometrial gene expression; endometrial receptivity; Endometrium - chemistry; Endometrium - physiopathology; Female; Fertility - genetics; Gene Expression Profiling; Gene Expression Regulation; Gene Regulatory Networks; Genetic Markers; Genetic Predisposition to Disease; Genomics - methods; Humans; infertility; Infertility, Female - diagnosis; Infertility, Female - genetics; Infertility, Female - physiopathology; Internal Medicine; metabolic syndrome; obesity; Obesity - complications; Obesity - diagnosis; Obesity - genetics; Obesity - physiopathology; Obstetrics and Gynecology; Phenotype; Pregnancy; Prospective Studies; Risk Factors; Spain; Texas; Transcriptome; metabolic syndrome; infertility; endometrial receptivity; Endometrial gene expression; obesity
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/j.fertnstert.2016.11.009

To analyze the transcriptomic profile of endometrial gene alterations during the window of implantation in infertile obese patients. Multicenter, prospective, case–control study. Three academic medical centers for reproductive medicine. Infertile patients, stratified into body mass index (BMI) categories according to the World Health Organization guidelines, were included in the study. Endometrial samples were obtained from women undergoing standardized estrogen and P replacement cycles after 5 days of vaginal P supplementation. 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. 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. 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. NCT02205866.