Does endometrial integrin expression in endometriosis patients predict enhanced in vitro fertilization cycle outcomes after prolonged GnRH agonist therapy?

ObjectiveTo determine whether endometrial expression of the integrin αvβ3 vitronectin can predict which endometriosis patient subgroup will benefit from pre-IVF cycle prolonged GnRH agonist (GnRHa) therapy.DesignProspective randomized institutional review board approved pilot trial.SettingPrivate assisted reproductive technology program.Patient(s)IVF candidates with regular menses, surgically confirmed endometriosis, and normal ovarian reserve.Intervention(s)All patients underwent endometrial biopsy 9 to 11 days post-LH surge to evaluate αvβ3 integrin expression. Patients were randomized either to receive depot leuprolide acetate 3.75 mg every 28 days for three doses before controlled ovarian hyperstimulation (COH) or to proceed directly to COH and IVF. Group 1: integrin-positive controls (N = 12); group 2: integrin-positive administered prolonged GnRHa (N = 8). Group A: integrin-negative controls (N = 7); group B: integrin-negative administered prolonged GnRHa (N = 9).Main Outcome Measure(s)COH responses, ongoing pregnancy and implantation rates.ResultsThere were no significant effects of GnRH agonist treatment in either of the integrin expression strata regarding ongoing pregnancy or implantation rates, although these outcomes were more frequent in group 2 vs. 1 (62.5% vs. 41.6% and 35% vs. 20.6%, respectively). This effect may have because of limited sample size. The value of a negative integrin biopsy in predicting an ongoing pregnancy after prolonged GnRH agonist therapy was only 44.4%.Conclusion(s)Endometrial αvβ3 integrin expression did not predict which endometriosis patients would benefit from prolonged GnRHa therapy before IVF.