Projects / Programmes
The impact of medicamentous or lifestyle intervention weight loss on endometrial gene expression and protein profile in infertile women with polycystic ovaries syndrome and obesitas
| Code |
Science |
Field |
Subfield |
| 3.05.00 |
Medical sciences |
Human reproduction |
|
| Code |
Science |
Field |
| B000 |
Biomedical sciences |
|
| Code |
Science |
Field |
| 3.02 |
Medical and Health Sciences |
Clinical medicine |
Obesity, polycystic ovaries syndrome, weight loss, endometrial receptivity, biomarkers
Researchers (22)
Organisations (3)
Abstract
Polycystic ovaries syndrome (PCOS) is the most common endocrinologic disease in reproductive period. It is associated with several reproductive and metabolic disorders. Obesity frequently accompanies PCOS. Obese women with PCOS have lower spontaneous and IVF pregnancy rates, higher miscarriage rates, lower live-born rates and higher complication rates during pregnancy. Causes of infertility in PCOS include anovulation, decreased oocyte quality and reduced endometrial receptivity. It is well known that even a small weight reduction in obese PCOS patients improves endocrine profile, menstrual cycle regularity and fertility thus, weight reduction isconsidered as a standard treatment of PCOS.
Embryo implantation represents a crucial step of the reproductive process.
Quality embryo, appropriate endometrial receptivity and synchronous dialog between them are needed during the window of implantation (WOI) for successful implantation. Endometrial gene expression of women with high body mass index (BMI) during the WOI differs from gene expression of women with normal BMI, especially if obesity is combined with infertility. Genes related to embryo implantation have been shown to be differentially expressed in these women. It is also known that expression of androgen and estrogen receptor genes in endometrium of overweight women with PCOS differs before and after weight reduction.
The purpose of the proposed project is to analyse transcriptome and proteome of endometrial cavity fluid during the WOI and determine whether there are biomarkers of successful embryo implantation in in vitro fertilization (IVF) procedures. Furthermore, we want to determine how the transcriptome and proteome of endometrial cavity fluid of obese (BMI ) 30 kg/m2) women with PCOS during the WOI change after weight loss by using medication or a combination of diet and exercise. We will compare these results with transcriptome and proteome of endometrial cavity fluid during the WOI of women with normal BMI (18.5 – 24.9 kg/m2), who will get pregnant in IVF procedures. With these analyses we want to determine which one of the weight reduction programmes leads towards more phyisiological changes of endometrium on molecular level.
Significance for science
Analysis of gene and protein expression in endometrial fluid before and after weight reduction will help us better understand mechanisms of lower IVF success rates in obese PCOS women. Discovery of biomarkers of endometrial receptivity / WOI would enable us to use them in everyday clinical practice for determination of optimal timing of embryo transfer in each individual patient. The use of biomarkers would lower the number of IVF cycles needed to achieve birth of a child. This would lower financial burden on public healthcare system as six IVF cycles in Slovenia are fully reimbursed by health insurance. It would also lower psychophysical burden of infertile women and couples.
Body weight reduction in obese PCOS women will lower the incidence of obstetric and pregnancy associated complications, maternal and neonatal morbidity and mortality. This will importantly reduce the financial burden of treatment of pregnancy associated complications and lower the need for neonatal intensive care.
The proposed research project represents an original benefit to reproductive medicine as there is a great chance that the results of the study will be used in everyday clinical practice.
17.1. Relevance to the development of science or a scientific field
Discovery of biomarkers of endometrial receptivity / WOI would enable us to use them in everyday clinical practice for determination of optimal timing for embryo transfer in IVF procedures for each individual patient. This way IVF procedures would become more individualised. The use of biomarkers would lower the number of IVF cycles needed to achieve a birth of a child. This would lower financial burden on public healthcare system as six IVF cycles in Slovenia are fully reimbursed by health insurance. It would also lower psychophysical burden for infertile women and their partners.
Significance for the country
Weight reduction lowers the incidence of cardiovascular diseases later in life. This lowers the need for the use of antihypertensive medications, medications for treatment of diabetes and dyslipidemia - conditions that have a higher incidence in obese people. Besides that sick leave costs due to these conditions will be lowered.
Most important scientific results
Final report
Most important socioeconomically and culturally relevant results
Final report
