Altered circulating levels of matrix metalloproteinases 2 and 9 and their inhibitors and effect of progesterone supplementation in women with endometriosis undergoing in vitro fertilization

Overexpression of matrix metalloproteinases (MMPs) 2 and 9 and decrease in tissue inhibitor of MMP (TIMP) 1 were associated with poor IVF outcome in women with endometriosis. Progesterone supplementation following IVF improved the MMP-9/TIMP-1 imbalance significantly in these women.

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Authors

Abhay Kumar Singh, M.Sc., Ratna Chattopadhyay, M.B.B.S., Baidyanath Chakravarty, M.D., Koel Chaudhury, Ph.D.

Volume 100, Issue 1, Pages 127-134.e1, July 2013

Abstract

Objective:

To investigate differences in the activity of matrix metalloproteinases (MMPs) 2 and 9 and their respective tissue inhibitors (TIMPs) in follicular fluid of women with endometriosis, to correlate the findings with IVF outcome, and to examine the therapeutic potential of progesterone supplementation in restoring the fine balance between MMPs and TIMPs.

Design:

Prospective case-control clinical study.

Setting:

Infertility clinic and reproductive health research unit.

Patient(s):

A total of 340 infertile women undergoing IVF.

Intervention(s):

Natural micronized progesterone capsules were administered for luteal support.

Main Outcome Measure(s):

Association of MMPs 2 and 9 and TIMP-1 with oocyte maturity and embryo development.

Result(s):

An abnormal expression of MMP-2, MMP-9, and TIMP-1 with extensive MMP-9/TIMP-1 imbalance in women with endometriosis undergoing IVF was observed. Transforming growth factor β1 plays an important role in these women with possible involvement of Smad-2 and -3 proteins. Progesterone supplementation improves the imbalance in MMP-9/TIMP-1 ratio significantly in women with endometriosis who conceive after IVF.

Conclusion(s):

Increase in MMP-2 and -9 and decrease in TIMP-1 expression was associated with poor oocyte and embryo development in women with endometriosis undergoing IVF. MMP-9/TIMP-1 balance was highly affected in these women, and progesterone supplementation appeared to restore this imbalance to a considerable degree.

Read the full text at: http://www.fertstert.org/article/S0015-0282(13)00407-X/fulltext


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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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