Vol 91, No 5 (2020)
Research paper
Published online: 2020-05-29

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The correlation between unexplained infertility and exosomes

Yıldız Uyar1, Melike Özgül1, Sevtap Gökap1, Gülay Ok1, Ayça Tan1, Hafize Seda Vatansever1
Pubmed: 32495928
Ginekol Pol 2020;91(5):240-246.


Objectives: Endometrial receptivity plays the most important role for successful implantation. Increasing endometrial
receptivity may improve infertility and increase Assisted Reproductive Technologies success. The aim of this study was to
investigate the effect of exosome specific markers CD63 and CD9 which are promising molecules in the pathogenesis and
treatment of many diseases on endometrial receptivity in women with unexplained infertility.
Material and methods: This prospective study was conducted between November 2015 and March 2017. Proliferation
and secretion periods of endometrial samples from fertile and infertile cases were collected. The paraffin-embedded
tissue sections were stained with hematoxylin-eosin for the immunohistochemical analysis distributions of CD63 and CD9.
Results: The results of this study demonstrated that the CD63 immunoreactivity was higher in both luminal and glandular
epithelium of infertile patients when compared with fertile patients during the proliferative phase (p = 0.009, p = 0.008). In
the infertile proliferation phase, endometrium CD9 immunoreactivity was rarely detected in both the luminal and glandular
epithelium. In the secretion phase of endometrium, CD9 immunoreactivity was mild in fertile patients, the increased
immunoreactivity of CD9 was observed in both luminal and glandular epithelium of infertile patients (p = 0.037, p = 0.037).
Conclusions: Increased levels of CD63 in infertile proliferation phase endometrium should represent an unfavorable
signaling. Moreover, the increased levels of CD9 in infertile secretion phase endometrium could be used as a biomarker
to evaluate endometrial receptivity. These exosome-specific markers can be considered as potential molecular markers
of infertility.

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