Status of nucleolar channel systems in uterine secretions accurately reflects their prevalence—a marker for the window of implantation—in simultaneously obtained endometrial biopsies

Nucleolar channel systems, markers of the endometrial window of implantation, can be detected noninvasively in uterine secretions, and their status reflects their prevalence in biopsies.

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Volume 109, Issue 1, Pages 165–171

Authors:

Fangyin Meng, M.D., Ph.D., Gregory Zapantis, M.D., Samuel Z. Williams, M.D., Ph.D., Harry J. Lieman, M.D., Erkan Buyuk, M.D., U. Thomas Meier, Ph.D.

Abstract:

Objective

To assess whether nucleolar channel systems (NCSs) can be detected in exfoliated endometrial epithelial cells (EECs) of uterine secretions and whether such noninvasively determined NCS status is associated with significant NCS prevalence in simultaneously obtained endometrial biopsies.

Design

Prospective study (December 2015–February 2017).

Setting

University-affiliated and private fertility clinics.

Patient(s)

Luteal-phase patients of reproductive age requiring endometrial biopsy for medical indications.

Intervention(s)

Uterine secretion aspiration before endometrial biopsy. Cells in uterine secretions were spun onto slides and fixed. NCSs were identified and quantified in cells and paraffin-embedded tissue sections by indirect immunofluorescence.

Main Outcome Measure(s)

Comparison of NCS status of uterine secretions with NCS prevalence in biopsies. Based on NCS detection, uterine secretions were assigned a status of NCS-positive (n = 15) or NCS-negative (n = 7). NCS prevalence in biopsies was expressed as a percentage of NCSs per EECs.

Result(s)

NCSs can be detected in exfoliated EECs of uterine secretions. Median NCS prevalence in endometrial biopsies from patients with NCS-positive secretions was 41.9% (interquartile range [IQR], 21.1–53.9) versus 2.0% (IQR, 0–6.9) when secretions were NCS-negative. The NCS status of secretions identified a significant difference in NCS prevalence of simultaneously obtained biopsies.

Conclusion(s)

NCS status of secretions accurately reflects NCS prevalence of biopsies, a marker for the implantation window. As secretion aspiration is compatible with same-day ET, our study provides proof of principle for a minimally invasive approach to determine endometrial receptivity for timing frozen ET.


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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.

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