Decidualization score identifies an endometrial dysregulation in samples from women with recurrent pregnancy losses and unexplained infertility.
Decidualization score identifies an endometrial dysregulation in samples from women with recurrent pregnancy losses and unexplained infertility.
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deDualization评分确定了来自复发妊娠损失和无法解释的不孕症的女性的样本中的子宫内膜失调。
DOI：
10.1016/j.xfre.2020.12.004
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发表时间：
2021-03
期刊：
影响因子：
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通讯作者：
Coulam C
中科院分区：
文献类型：
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作者：
Dambaeva S;Bilal M;Schneiderman S;Germain A;Fernandez E;Kwak-Kim J;Beaman K;Coulam C
目的：研究蜕膜化相关子宫内膜因素。回顾性队列研究，比较生育失败妇女的子宫内膜基因表达模式，包括反复妊娠丢失或不明原因不孕与生育对照组。大学生殖医学中心。反复生育失败的妇女(n=42)和生育对照组(n=18)，其中包括反复妊娠丢失或原因不明的不孕。通过下一代测序，对子宫内膜活检样本进行靶向核糖核酸测序。主要的终点测量是蜕膜化过程中对子宫内膜转化重要的基因的表达，单独测量和综合/累积计分方法。次级终点测量是受试者工作曲线分析和特定生物标志物之间的比较。比较发现，与蜕膜化、组织动态平衡和免疫调节相关的因子存在差异：Foxo1、GZMB、IL15、SCNN1A、SGK1和SLC2A1。这6个标志性因素的综合评价被指定为蜕膜化评分，其中最高分为“6”，最低分为“0”。在对照组中，89%的样本≥为5，11%的样本得分为4。患者组中共有76%的样本的≤评分为4，19%的样本的最低评分为“0”。蜕膜化评分4分提供蜕膜化过程异常的证据，其敏感性为76%(95%CI 61%~88%)，特异性89%(95%CI 65%~99%)。蜕膜化评分可以确定子宫内膜分子图谱是否有利于植入。有必要进一步验证这种检测方法，以确定特定的患者群体，在体外受精程序之前，该方法可用于选择需要采取治疗行动以改善子宫内膜状况的患者。
To study decidualization-associated endometrial factors. Retrospective cohort study to compare endometrial gene expression patterns in women experiencing reproductive failure including recurrent pregnancy loss or unexplained infertility versus fertile controls. University Reproductive Medicine Center. Women experiencing recurrent reproductive failure including recurrent pregnancy loss or unexplained infertility (n = 42) and fertile controls (n = 18). Endometrial biopsy samples were analyzed with targeted ribonucleic acid sequencing via next-generation sequencing. The primary end point measurements were the expression of genes important for endometrial transformation during decidualization measured singly and in a combined/cumulative score approach. The secondary end point measurements were receiver operating curve analysis and comparisons between the specific biomarkers. The comparison revealed differential expression of factors associated with decidualization, tissue homeostasis, and immune regulation: FOXO1, GZMB, IL15, SCNN1A, SGK1, and SLC2A1. A combined evaluation of these 6 signature factors was designated as a decidualization score in which the maximal score was “6” and the minimal was “0”. Among controls, 89% of the samples had a score ≥5 and 11% had a score of “4”. A total of 76% of samples in the patient group had scores ≤4 and 19% had the lowest score of “0”. A decidualization score <4 provided evidence of abnormality in the decidualization process with a sensitivity of 76% (95% CI 61%-88%) and specificity of 89% (95% CI 65%-99%). Decidualization scoring can determine whether the endometrial molecular profile is implantation-friendly. Further validation of this testing approach is necessary to determine a particular patient population in whom it could be used for selecting patients that require therapeutic actions to improve endometrial conditions prior to the in vitro fertilization procedure