Role of an estrogen-upregulated 64.0-kDa uterine fluid glycoprotein in improving fertility in women

ObjectiveTo evaluate the significance of an estrogen-upregulated 64.0-kDa human uterine fluid (hUF) glycoprotein in relation to promotion of fertility.DesignProspective study.SettingDepartment of Assisted Reproductive Biology Unit, Institute of Reproductive Medicine, Kolkata. India.Patient(s)Sixty-three women with unexplained infertility having normal ovulatory cycle with normal endocrine profile and 18 parous women.Intervention(s)Women either received no stimulation (n = 35) or were stimulated with clomiphene citrate (CC) alone (100 mg/day from day 3 to day 7; n = 56) or in combination with pure FSH (75 IU on day 3 and day 8; n = 54) and were subjected to IUI. Parous women (n = 18) receiving no treatment served as control and were followed-up for spontaneous ovulation.Main Outcome Measure(s)Uterine fluid protein profile, relative intensity of 64.0-kDa protein, number of mature follicles, endometrial thickness, and pregnancy.Result(s)Expression of the 64.0-kDa protein exhibited positive correlation with prevailing estradiol levels, but the degree of the protein response to estrogen was comparatively blunted in the CC-incorporated cycles. Endometrial thickness and pregnancy outcomes correlated positively with the expression of the protein.Conclusion(s)The 64.0-kDa hUF protein perhaps plays a role in endometrial receptivity to support pregnancy. Failure of pregnancy despite documented ovulation in CC-stimulated cycles may be due to its attenuating effects on expression of the protein.