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.