TY - JOUR
T1 - Decidual endovascular trophoblast invasion in women with polycystic ovary syndrome
T2 - An experimental case-control study
AU - Palomba, Stefano
AU - Russo, Tiziana
AU - Falbo, Angela
AU - Di Cello, Annalisa
AU - Amendola, Giuseppina
AU - Mazza, Rosa
AU - Tolino, Achille
AU - Zullo, Fulvio
AU - Tucci, Luigi
AU - La Sala, Giovanni Battista
PY - 2012/7
Y1 - 2012/7
N2 - Context: Previous experimental and clinical data suggest impaired decidual trophoblast invasion in patients with polycystic ovarian syndrome (PCOS). Objective: Theobjective ofthestudywasto testthehypothesis that decidual endovascular trophoblast invasion in pregnant patients with PCOS is impaired and to clarify the potential mechanisms involved. Design: This was an experimental case-control study. Setting: The study was conducted at the academic Departments of Obstetrics and Gynecology and the Unit of Pathology (Italy). Patients: Forty-five pregnant subjects screened from a wide population ofwomenwaiting for legal pregnancy termination were included in the final analysis. Specifically, 15 pregnant patients with PCOS were enrolled as cases and another 30 age- and body mass index (BMI)-matched healthy pregnant women without any feature of PCOS were enrolled as the controls. Intervention: Interventions included the collection of trophoblastic and decidual tissue at the 12th week of gestation. Main Outcome Measures: Clinical, ultrasonographic, and biochemical data as well as the histological analysis of decidual endovascular trophoblast invasion. Results: The rate of implantation site vessels with endovascular trophoblast invasion (ratio between total number of implantation site vessels and total number of vessels with endovascular trophoblast invasion) and the extent of endovascular trophoblast invasion (proportion between immunoreactive areas to cytokeratin 7 and to CD34) were significantly lower in patients with PCOS compared with healthy non-PCOS controls. Endovascular trophoblast invasion data were significantly and indirectly related to the markers of insulin resistance and testosterone concentrations in PCOS patients. Conclusions: Pregnant patients with PCOS patients have impaired decidual trophoblast invasion. Further studies are needed to evaluate the exact mechanisms through which insulin resistance and hyperandrogenemia exert this effect.
AB - Context: Previous experimental and clinical data suggest impaired decidual trophoblast invasion in patients with polycystic ovarian syndrome (PCOS). Objective: Theobjective ofthestudywasto testthehypothesis that decidual endovascular trophoblast invasion in pregnant patients with PCOS is impaired and to clarify the potential mechanisms involved. Design: This was an experimental case-control study. Setting: The study was conducted at the academic Departments of Obstetrics and Gynecology and the Unit of Pathology (Italy). Patients: Forty-five pregnant subjects screened from a wide population ofwomenwaiting for legal pregnancy termination were included in the final analysis. Specifically, 15 pregnant patients with PCOS were enrolled as cases and another 30 age- and body mass index (BMI)-matched healthy pregnant women without any feature of PCOS were enrolled as the controls. Intervention: Interventions included the collection of trophoblastic and decidual tissue at the 12th week of gestation. Main Outcome Measures: Clinical, ultrasonographic, and biochemical data as well as the histological analysis of decidual endovascular trophoblast invasion. Results: The rate of implantation site vessels with endovascular trophoblast invasion (ratio between total number of implantation site vessels and total number of vessels with endovascular trophoblast invasion) and the extent of endovascular trophoblast invasion (proportion between immunoreactive areas to cytokeratin 7 and to CD34) were significantly lower in patients with PCOS compared with healthy non-PCOS controls. Endovascular trophoblast invasion data were significantly and indirectly related to the markers of insulin resistance and testosterone concentrations in PCOS patients. Conclusions: Pregnant patients with PCOS patients have impaired decidual trophoblast invasion. Further studies are needed to evaluate the exact mechanisms through which insulin resistance and hyperandrogenemia exert this effect.
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U2 - 10.1210/jc.2012-1100
DO - 10.1210/jc.2012-1100
M3 - Article
C2 - 22508703
AN - SCOPUS:84863606049
VL - 97
SP - 2441
EP - 2449
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 7
ER -