Document Type : Original Article
Faculty of Development of Biology, University of Science and Culture, Tehran, Iran
Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
Department of Photo Healing and Regeneration, Medical Laser Research Center, Yara Institute Academic Center for Education, Culture and Research (ACECR), Tehran, Iran
Background: Polycystic ovary syndrome (PCOS) is a common endocrinological disorder associated with abdominal
obesity (AO) and some reproductive complications including low pregnancy rate. Embryo-endometrium cross-talk
has a key role in successful embryo implantation and subsequent normal pregnancy rate. The primary objective of
this study is to evaluate the decidualization potential of endometrial stromal cells (ESCs) using the embryo condition
media (ECM) collected from PCOS patients with AO, compared to ECM of those patients without AO.
Materials and Methods: In this experimental study, we measured the capacity of ECM collected from PCOS patients
with or without AO for decidualization induction in healthy ESCs after coculture. A total number of 53 embryos from
40 couples belonging to PCOS with AO, PCOS without AO, nonPCOS with AO, and nonPCOS without AO patients,
were included in our study. The embryosof four groups were single-cultured up to the blastocyst stage. Their ECM
(45λ/well) were pooled and added to healthy ESCs monolayer culture media to investigate their effects on decidualization
potential via gene (PRL, IGFBP1, IL1-β, HOXA10, IL-6 and TNF-α) and protein (PRL, IGFBP1, IL1-β)
expression analysis and ESCs migration assay.
Results: The morphological analysis, migration assay (P≤0.0321), protein (P≤0.0139) and gene expression analysis
showed PCOS with AO accounted for the highest gene (PRL, IGFBP1, IL1-β, HOXA10, IL-6, TNF-α) and protein
markers (PRL, IGFBP1, IL1-β) (P≤0.05). NonPCOS individuals without AO had the lowest level of both gene and
protein decidualization markers (P≤0.05).
Conclusion: Considering decidualization as an inflammatory process, a higher level of decidualization markers was
associated with a higher inflammatory status created by AO and PCOS, separately. Inflammation may disrupt the process
of inflammatory to anti-inflammatory phase required for prevention of pregnancy loss, this could explain the high
rate of abortion in these cases.