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Altered Expression of Interleukin-6, Glycodelin a and Heparin-Binding Epidermal Growth Factor, in the Endometrium of Women With Hydrosalpinx: A Case-Control Study Publisher



Shamlou N1 ; Zafarani F2 ; Aflatoonian R3 ; Aghajanpour S3 ; Lotfi M4 ; Zolfaghari Z3 ; Chekini Z3 ; Ghaffari F3 ; Kazerouni F1
Authors
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Authors Affiliations
  1. 1. Department of Laboratory Medicine, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
  3. 3. Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
  4. 4. Department of Pathology, Amir Alam Hospital, Tehran University of Medical Science, Tehran, Iran

Source: International Journal of Fertility and Sterility Published:2025


Abstract

Background: Hydrosalpinx is a recognized condition affecting the fallopian tubes, which decreases the embryo implantation rate and success in in vitro fertilization (IVF) outcomes. It can manifest detrimental effects through inflammatory conditions in the uterine endometrium that may lead to alterations in the expression of transcription factors and cytokines such as; Interleukin-6 (IL-6), Glycodelin A (GdA), and Heparin-binding epidermal growth factor (HB-EGF) involved in endometrial receptivity (ER) and embryo implantation. The alterations of these markers in the endometrium of patients with hydrosalpinx have not been investigated. Therefore, we aimed to evaluate the mRNA expression level of IL-6, HB-EGF, and GdA in the endometrium of women exposed to hydrosalpinx fluid (HF) compared to the fertile group. Materials and Methods: In this case-control study, 30 subjects were enrolled for this study: fifteen patients with communicating hydrosalpinx (aged between 20-37 years old) were compared with 15 fertile aged-matched egg donor women as the control group. All subjects underwent uterine endometrial sampling by Pipple on days 19-24 of the menstrual cycle. Gene expression was quantitatively analyzed using a real-time polymerase chain reaction (PCR) technique. Data analysis was conducted using the Wilcoxon rank test. Results: The mRNA expression level of IL-6 showed a significant increase in patients with hydrosalpinx compared to the control group (P=0.022). HB-EGF gene expression was significantly reduced in the hydrosalpinx group compared to fertile women (P=0.007). There was an insignificant decrease in GdA mRNA expression level compared to healthy fertile controls (P=0.419). Conclusion: The presence of hydrosalpinx led to an alteration in the expression of endometrial IL-6, HB-EGF, and GdA mRNA levels in the implantation window, which may explain the reduced implantation rate and success in IVF outcome. © 2025, Royan Institute (ACECR). All rights reserved.