HOXA-10 and E-cadherin expression in the endometrium of women with recurrent implantation failure and recurrent miscarriage

Endometrial HOXA-10 and E-cadherin expressions are reduced in women with recurrent implantation failure and recurrent miscarriage compared with fertile control women, suggesting that they play a role in the implantation process.

Like Comment

Volume 107, Issue 1, Pages 136-143


Yihua Yang, Ph.D., Xiaoyan Chen, M.Phil., Sotirios H. Saravelos, M.B.B.S., Yingyu Liu, M.Phil, Jin Huang, Ph.D., Jiamiao Zhang, M.Phil., Tin Chiu Li, M.D., Ph.D.



To compare the expression of HOXA-10 and E-cadherin in the endometrium of women with recurrent implantation failure (RIF), women with recurrent miscarriage (RM), and women with proven fertility (normal control; NC).


Observational cohort study.


University assisted reproductive unit.


Fifty women were recruited: 18 NC, 12 unexplained RIF, and 20 RM.



Main Outcome Measure(s)

Endometrial biopsy was precisely timed 7 days after LH surge. The expression of HOXA-10 and E-cadherin were examined by means of immunohistochemistry. H-Scores of staining intensity in the glandular epithelium and stroma were measured.


HOXA-10 signal was mainly localized in the nuclei of stroma cells and the cytoplasm of glandular epithelium cells. E-Cadherin signal was found only in the cytoplasm of glandular epithelium cells. The HOXA-10 H-scores in the RIF group and the RM group were significantly lower than in the control group in both the glandular epithelium and stroma. The E-cadherin H-scores in the RM group were also significantly lower than in the control group. Interestingly, there was a positive correlation between HOXA-10 and E-cadherin H-scores in all of the women examined.


There is a positive correlation between levels of HOXA-10 and E-cadherin expression in the endometrium, both of which are significantly reduced in women with RIF and RM compared with fertile control women. The findings suggest a potential role of HOXA-10 and E-cadherin in the implantation processes and altered expression in women with reproductive failure.

Read the full text here.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.


Go to the profile of Amanda Kallen
about 4 years ago
Thank you to the authors for this interesting study re: the association between reduced HOXA10 and e-cadherin expression in endometrium of women with implantation failure and recurrent miscarriage. The HOXA10 null mouse does show a failure of blastocyst implantation so the decreased HOXA10 expression in RIF patients seems to make sense. The findings in women with RM are particularly intriguing and I'd love to know more about the characteristics of this group. Were these women with clinical pregnancies (u/s documented) with implantation established already? Can the authors speculate on a potential mechanism for the link between HOXA10 and RM in this scenario? I also appreciate the authors' discussion on the findings re: age. Average age of the RM/RIF group was 36 vs 30 in control. As the authors do note an association between HOXA10 expression and age I would love to see this data presented with a control group in the same age range as well.