Effect of ormeloxifene, a selective estrogen receptor modulator, on biomarkers of endometrial receptivity and pinopode development and its relation to fertility and infertility in Indian subjects

• Published in: Fertility and sterility Vol. 91; no. 6; pp. 2298 - 2307
• Main Authors: Makker, Annu, Tandon, Indu, Goel, Madhu Mati, Singh, Mastan, Singh, Man Mohan
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.2009; Elsevier
• Subjects: Benzopyrans - therapeutic use; Biological and medical sciences; Birth control; contraceptive action; Embryo Implantation - drug effects; Embryo Implantation - physiology; Endometrial receptivity biomarkers; endometrial thickness; Endometrium - drug effects; Endometrium - physiology; Female; Fertility - drug effects; Fertility - physiology; fertility and infertility; Gynecology. Andrology. Obstetrics; histologic delay; hormone levels; Humans; Immunohistochemistry; India; Infertility, Female - physiopathology; Integrin alphaVbeta3 - genetics; Interleukin-6 - genetics; Internal Medicine; Leukemia Inhibitory Factor - genetics; Medical sciences; Obstetrics and Gynecology; ormeloxifene; pinopode development; Receptors, Estrogen - genetics; Receptors, Progesterone - genetics; Selective Estrogen Receptor Modulators - therapeutic use; Sterility. Assisted procreation; Asia; India; histologic delay; endometrial thickness; ormeloxifene; pinopode development; contraceptive action; fertility and infertility; Endometrial receptivity biomarkers; hormone levels; Human; Hormone; Gynecology; Biological marker; Obstetrics; Sterility; Thickness; Selective estrogen receptor modulator; Fertility; Development; Indian; Contraceptive; Ormeloxifene; Endometrium
• ISSN: 0015-0282; 1556-5653; 1556-5653
• DOI: 10.1016/j.fertnstert.2008.04.018

To compare expression of endometrial estrogen (ER) and progesterone (PR) receptors, β 3-integrin subunit, leukemia inhibitory factor (LIF), interleukin-6 (IL-6), and pinopodes in Indian women using ormeloxifene as a contraceptive with fertile and infertile subjects during the window of implantation. Controlled, prospective, clinical study. Hospital-based reproductive health unit and research laboratories. Thirteen fertile women, 6 using ormeloxifene (30 mg/week), 29 with primary and 10 with secondary infertility. Transvaginal ultrasonography, midluteal endometrial biopsies, and blood samples. Histologic dating, endometrial thickness, immunohistochemical localization of ER, PR, β 3-integrin subunit, LIF, and IL-6 and scanning electron microscopy. Ormeloxifene significantly reduced endometrial thickness, pinopode density, and caused histologic delay with increased epithelial ER and PR and unaltered epithelial β 3-integrin subunit expression. Appearance of fully developed pinopodes, down-regulation of epithelial PR, and increased epithelial β 3-integrin subunit expression was observed in in-phase endometrium from fertile and infertile women. LIF and IL-6 expression and serum estradiol and progesterone levels remained unaltered between groups. Ormeloxifene-induced effects might produce asynchrony between endometrial and embryo development resulting in implantation failure. Based on unaltered luteal phase serum progesterone concentration, ormeloxifene did not appear to prevent ovulation in any participant.