By I Soussis MD
Deficiency of a protein in the womb has been identified as the reason why endometriosis causes infertility, according to a new study published in Science Translational Medicine.
American and South Korean researchers investigated the link between endometriosis and infertility. In endometriosis, womb-lining tissue grows outside of the uterus, often on the ovaries and fallopian tubes. This can lead to chronic pain and is associated with infertility, but the mechanism has been unclear.
“Around ten percent of women have endometriosis and up to 50 percent of endometriosis patients have infertility”, said lead author Dr Jae-Wook.
The scientists compared endometrial tissue from 21 women with endometriosis and infertility with samples from healthy women.
They observed that levels of a protein called histone deacetylase 3 (HDAC3) in the lining of the uterus of women with endometriosis were lower compared to healthy women. Previously developed animal models of endometriosis in mice and baboons supported this finding.
The team then developed mice unable to produce HDAC3 in uterine cells, all of which were infertile. Dr Jeong and his colleagues were able to show that HDAC3 is necessary for embryo to implant in the womb. Follow-up experiments with human endometrial cells cultured in vitro showed that HDAC3 is a crucial part of the changes that occur in the uterus, in preparation for and during pregnancy.
This study could help endometriosis patients and their doctors select more effective treatments and enable a better understanding of female infertility.
Finally, the enigma of endometriosis starts to unravel. This is a significant study that shows for the first time that the levels of HDAC3 are crucial for the development of fertile endometrium. This line of research may lead to new treatments for endometriosis caused infertility.
It may also help in cases of recurrent implantation failure in IVF patients without endometriosis.