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Projects / Programmes source: ARIS

Comparison of endometrial gene expression during the window of implantation in obese women with polycystic ovaries syndrome before and after weight reduction with pharmacological or lifestyle intervention

Research activity

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 
Keywords
Obesity, endometrial receptivity, biomarkers, weight loss, polycystic ovaries syndrome
Evaluation (rules)
source: COBISS
Researchers (1)
no. Code Name and surname Research area Role Period No. of publicationsNo. of publications
1.  33343  PhD Tanja Burnik Papler  Human reproduction  Head  2019 - 2021  54 
Organisations (1)
no. Code Research organisation City Registration number No. of publicationsNo. of publications
1.  0312  University Medical Centre Ljubljana  Ljubljana  5057272000  77,480 
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 endometrial transcriptome 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 endometrial transcriptome of obese (BMI ) 30 kg/m2) women with PCOS during the WOI changes after weight loss by using medication or a combination of diet and exercise. We will compare these results with endometrial transcriptome of women with normal BMI (18.5 – 24.9 kg/m2) obtained during the WOI, who will get pregnant in IVF procedures. With these analyses we want to determine which one of the weight reduction programs leads towards more phyisiological changes of endometrium on molecular level.
Significance for science
Analysis of endometrial gene expression 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.
Significance for the country
Analysis of endometrial gene expression 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.
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