Lectin binding of endometrium in women with unexplained infertility.

OBJECTIVE

To investigate whether peri-implantation phase endometrium in women with unexplained infertility differs from the endometrium of normal fertile women.

DESIGN

Assessment of the function of the endometrium by using endometrial biopsy specimens and lectin histochemistry.

SETTING

Infertility Clinic, Jessop Hospital for Women, Sheffield, United Kingdom.

PATIENTS

Eighteen normal fertile women (group I) and 18 women with unexplained infertility (group II).

INTERVENTIONS

Endometrial biopsies were obtained from both groups at 5, 7, and 9 days after the luteinizing hormone (LH) surge.

MAIN OUTCOME MEASURES

Five biotinylated lectins, concanavalin A (ConA), wheat germ agglutinin (WGA), soybean agglutinin, Peanut, and Ulex europaeus I were used as analytical probes to study endometrial glycoconjugates. Histochemical staining was performed using the avidin-biotin peroxidase method. The lectin binding by endometrial glands, surface epithelium, stromal cells, and vessels was assessed.

RESULTS

In group I, ConA stained the subnuclear glandular cytoplasm, glandular lumen, stroma cells, and surface epithelium. In group II, ConA binding to glandular or surface epithelium was none or equivocal. In group I, WGA bound to glandular cytoplasm and stroma cells on days LH + 5 and LH + 7. In group II, WGA binding was absent in glands but present in stroma.

CONCLUSIONS

Reproductive failure of women with unexplained infertility may be associated with defective biosynthesis and distribution of glycoconjugates that subsequently results in an unfavorable endometrial environment during the peri-implantation phase.