Infertile women with isolated polycystic ovaries are deficient in endometrial expression of osteopontin but not αvβ3 integrin during the implantation window

Objective: To characterize possible endometrial defects in infertile women with isolated PCO morphology. Design: Prospective study. Setting: An academic hospital with an IVF unit. Patient(s): Women with primary unexplained infertility and isolated PCO, fertile women, and women With infertility secondary to male factor. Intervention(S): Thirty-one women (fertile and with male factor infertility) had endometrial sampling across the menstrual cycle. Nine fertile women and 10 infertile women with isolated PCO had sampling on day LH +7, adjusted for histologic dating. Main Outcome Measure(s): Expression of alpha v beta 3 and its ligand, osteopontin, were determined using real-time quantitative polymerase chain reaction and immunohistochemistry. In vitro regulation of osteopontin was assessed using the Ishikawa cell line. Result(s): Cyclic variations revealed a fall in integrin alpha v beta 3 mRNA during the secretory phase with concomitant up-regulation of osteopontin mRNA. Immunohistochemistry on day LH +7 demonstrated a significant reduction in expression of osteopontin in the isolated PCO group with no difference in expression of alpha v beta 3. In vitro studies confirmed Up-regulation of osteopontin by estrogen with no apparent effect of androgen. Conclusion(s): These results demonstrate an apparent reduction of osteopontin expression, important in cell-cell adhesion, during the window of implantation in infertile women with isolated PCO morphology. (Fertil Steril (R) 2009;91:489-99. (C)2009 by American Society for Reproductive Medicine.)