Different types of recurrent miscarriage are associated with varying patterns of adhesion molecule expression in endometrium

This study investigated the hypothesis that different types of recurrent miscarriage history are associated with different markers of endometrial receptivity. A secondary objective was to compare the distribution in endometrial epithelium of a group of cell surface components with roles in cell adhesion. Of 54 women who had an implantation window endometrial biopsy, 17 had idiopathic recurrent fetal loss, 17 had idiopathic recurrent loss of empty gestation sacs, 10 had recurrent implantation failure and 10 had two or more normal pregnancies. Immunohistochemistry and HSCORE was used with frozen sections for integrins (α1β1, α4β1, αvβ3), and MUC1 (BC2) and paraffin sections for osteopontin and MUC1 (BC3). Epithelial β1 integrins were located primarily in the basolateral membrane compartment. Consistently greater expression of α4β1, α1β1 and αvβ3 was seen in the luminal epithelium and greater expression of α4β1 and α1β1 in the glandular epithelium of women with recurrent fetal loss when compared with those with recurrent loss of empty gestation sacs. There were no significant differences in the expression of osteopontin or MUC1 between groups. Different endometrial integrin distribution was found in women suffering different types of recurrent pregnancy loss. It is postulated that impairment of the implantation barrier contributes to recurrent fetal loss.