Skip to main content

Advertisement

SpringerLink
Log in

Laparoscopic Ovarian Drilling Improves Endometrial Homeobox Gene Expression in PCOS

  • Original Article
  • Published:
Reproductive Sciences Aims and scope Submit manuscript

Abstract

The study was designed to investigate whether laparoscopic ovarian drilling (LOD) of ovaries alters the expression levels of HOXA-10 and HOXA-11 mRNA in the endometrium of infertile women with clomiphene-resistant PCOS. Expression of HOXA-10 and HOXA-11 mRNA in the endometrium obtained before and after LOD during the midsecretory phase was measured. Expression of each gene was evaluated using real-time reverse transcriptase polymerase chain reaction (RT-PCR). Expression levels of HOXA-10 and HOXA-11 mRNA were lower in endometrium of patients with PCOS before LOD compared with fertile controls. But the differences failed to show statistical significance. Compared with fertile subjects, LOD of PCOS ovaries up-regulated endometrial HOXA-10 and HOXA-11 mRNA expression. Fold changes of HOXA-10 and HOXA-11 mRNA after LOD were found to be 4.46 and 4.19, respectively. Fold change increase in HOXA-10 and HOXA-11 mRNA was found to be statistically significant (P < .01, P < .02). There is a receptivity defect in the endometrium of women with PCOS that affects fertility regardless of other causes of infertility. LOD increases endometrial HOXA-10 and HOXA-11 mRNA expressions and improves receptivity in patients with clomiphene-resistant PCOS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bellver J, Martínez-Conejero JA, Labarta E, et al. Endometrial gene expression in the window of implantation is altered in obese women especially in association with polycystic ovary syndrome. Fertil Steril. 2011;95:2335–41.

    Article  CAS  Google Scholar 

  2. Apparao KB, Lovely LP, Gui Y, Lininger RA, Lessey BA. Elevated endometrial androgen receptor expression in women with polycystic ovarian syndrome. Biol Reprod. 2002;66:297–304.

    Article  CAS  Google Scholar 

  3. Cermik D, Selam B, Taylor HS. Regulation of HOXA-10 expression by testosterone in vitro and in the endometrium of patients with polycystic ovary syndrome. J Clin Endocrinol Metab. 2003;88:238–43.

    Article  CAS  Google Scholar 

  4. Elnashar A, Fouad H, Eldosoky M, Saeid N. Letrozole induction of ovulation in women with clomiphene citrate-resistant polycystic ovarysyndrome may not depend on the period of infertility, the body mass index, or the luteinizing hormone/follicle-stimulating hormone ratio. Fertil Steril. 2006;85:511–3.

    Article  CAS  Google Scholar 

  5. Abu Hashim H, Al-Inany H, De Vos M, Tournaye H. Three decades after Gjönnaess’s laparoscopic ovarian drilling for treatment of PCOS; what do we know? An evidence-based approach. Arch Gynecol Obstet. 2013;288:409–22.

    Article  Google Scholar 

  6. Nahuis MJ, Oude Lohuis EJ, Bayram N, Hompes PG, Oosterhuis GJ, van der Veen F, et al. Pregnancy complications and metabolic disease in women with clomiphene citrate-resistantanovulation randomized to receive laparoscopic electrocautery of the ovaries or ovulation induction with gonadotropins: a 10-yearfollow-up. Fertil Steril. 2014;101:270–4.

    Article  CAS  Google Scholar 

  7. Abdellah MS. Reproductive outcome after letrozole versus laparoscopic ovarian drilling for clomiphene-resistant polycystic ovary syndrome. Int J Gynaecol Obstet. 2011;113:218–21.

    Article  CAS  Google Scholar 

  8. Ibrahim MH, Tawfic M, Hassan MM, Sedky OH. Letrozole versus laparoscopic ovarian drilling in infertile women with PCOS resistant to clomiphene citrate. Middle East Fertil Soc J. 2017;22:251–4.

    Article  Google Scholar 

  9. Yu Q, Hu S, Wang Y, Cheng G, Xia W, Zhu C. Letrozole versus laparoscopicovarian drilling in clomiphene citrate-resistant women with polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Reprod Biol Endocrinol. 2019;17:17.

    Article  Google Scholar 

  10. Franik S, Eltrop SM, Kremer JA, Kiesel L, Farquhar C. Aromatase inhibitors (letrozole) for subfertile women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2018;24(5):CD010287.

    Google Scholar 

  11. Block K, Kardana A, Igarashi P, Taylor HS. In utero diethylstilbestrol (DES) exposure alters Hox gene expression in the developing mu¨ llerian system. FASEB J. 2000;14:1101–8.

    Article  CAS  Google Scholar 

  12. Satokata I, Benson G, Maas R. Sexually dimorphic sterility phenotypes in Hoxa10-deficient mice. Nature. 1995;374:460–3.

    Article  CAS  Google Scholar 

  13. Taylor HS, Arici A, Olive DL, Igarashi P. HOXA10 is expressed in response to sex steroids at the time of implantation in the human endometrium. J Clin Invest. 1998;101:1379–84.

    Article  CAS  Google Scholar 

  14. Taylor HS, Igarashi P, Olive DL, Arici A. Sex steroids mediate HOXA11 expression in the human peri-implantation endometrium. J Clin Endocrinol Metab. 1999;84:1129–35.

    CAS  PubMed  Google Scholar 

  15. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81:19–25.

    Google Scholar 

  16. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.

    Article  CAS  Google Scholar 

  17. El-Sayed MLM, Ahmed MA, Mansour MAA, Mansour SAA. Unilateral versus bilateral laparoscopic ovarian drilling using thermal dose adjusted according to ovarian volume in CC-resistant PCOS, a randomized study. J Obstet Gynaecol India. 2017;67:356–62.

    Article  Google Scholar 

  18. Celik O, Unlu C, Otlu B, Celik N, Caliskan E. Laparoscopic endometrioma resection increases peri-implantation endometrial HOXA-10 and HOXA-11 mRNA expression. Fertil Steril. 2015;104:356–65.

    Article  CAS  Google Scholar 

  19. Gregory CW, Wilson EM, Apparao KB, et al. Steroid receptor coactivator expression throughout the menstrual cycle in normal and abnormal endometrium. J Clin Endocrinol Metab. 2002;87:2960–6.

    Article  CAS  Google Scholar 

  20. Giudice LC. Endometrium in PCOS: implantation and predisposition to endocrine CA. Best Pract Res Clin Endocrinol Metab. 2006;20:235–44.

    Article  CAS  Google Scholar 

  21. Donaghay M, Lessey BA. Uterine receptivity: alterations associated with benign gynecological disease. Semin Reprod Med. 2007;25:461–75.

    Article  CAS  Google Scholar 

  22. Tulppala M, Stenman UH, Cacciatore B, Ylikorkala O. Polycystic ovaries and levels of gonadotrophins and androgens in recurrent miscarriage: prospective study in 50 women. Br J Obstet Gynaecol. 1993;100:348–52.

    Article  CAS  Google Scholar 

  23. Savaris RF, Groll JM, Young SL, DeMayo FJ, Jeong JW, Hamilton AE, et al. Progesterone resistance in PCOS endometrium: a microarray analysis in clomiphene citratetreated and artificial menstrual cycles. J Clin Endocrinol Metab. 2011;96:1737–46.

    Article  CAS  Google Scholar 

  24. Utiger RD. Insulin and the polycystic ovary syndrome. N Engl J Med. 1996;335:657–8.

    Article  CAS  Google Scholar 

  25. Bildirici I, Bukulmez O, Ensari A, Yarali H, Gurgan T. A prospective evaluation of the effect of salpingectomy on endometrial receptivity in cases of women with communicating hydrosalpinges. Hum Reprod. 2001;16:2422–6.

    Article  CAS  Google Scholar 

  26. Celik O, Aydin S, Celik N, Yilmaz M. Peptides: basic determinants of reproductive functions. Peptides. 2015;72:34–43.

    Article  CAS  Google Scholar 

  27. Wang J, Dicken C, Lustbader JW, Tortoriello DV. Evidence for a mullerian-inhibiting substance autocrine/paracrine system in adult human endometrium. Fertil Steril. 2008;5.

  28. Chen X, Mo Y, Li L, Chen Y, Li Y, Yang D. Increased plasma metastin levels in adolescent women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2010;149:72–6.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Faculty of Medicine, Department of Obstetrics and Gynecology, Recep Tayyip Erdogan University, Rize, Turkey

    Senol Senturk

  2. Private Clinic, Obstetrics and Gynecology, Usak, Turkey

    Onder Celik

  3. Faculty of Science, Department of Biology Molecular Biology and Genetics, Fırat University, Elazig, Turkey

    Semih Dalkilic

  4. Medicana Samsun International Hospital IVF Unit, Samsun, Turkey

    Safak Hatirnaz

  5. Department of Biochemistry, Behcet Uz Children’s Hospital, Izmir, Turkey

    Nilufer Celik

  6. Department of Obstetrics and Gynecology, School of Medicine, Acıbadem University, Istanbul, Turkey

    Cihat Unlu

  7. Department of Medical Microbiology, School of Medicine, Inonu University, Malatya, Turkey

    Baris Otlu

Authors
  1. Senol Senturk
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Onder Celik
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Semih Dalkilic
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Safak Hatirnaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nilufer Celik
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Cihat Unlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Baris Otlu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Onder Celik.

Ethics declarations

The study was performed according to the guidelines of the Helsinki Declaration on human experimentation and was approved by the Local Ethics Committee.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Senturk, S., Celik, O., Dalkilic, S. et al. Laparoscopic Ovarian Drilling Improves Endometrial Homeobox Gene Expression in PCOS. Reprod. Sci. 27, 675–680 (2020). https://doi.org/10.1007/s43032-019-00072-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s43032-019-00072-x

Keywords

Search

Navigation