Fertility and Sterility
Volume 92, Issue 6 , Pages 1820-1824, December 2009

Decreased endometrial HOXA10 expression associated with use of the copper intrauterine device

  • Amy M. Tetrault, B.S., M.S.
    • ,
  • Susan M. Richman, M.D.
    • ,
  • Xiaolan Fei, M.D.
    • ,
  • Hugh S. Taylor, M.D.

      Affiliations

    • Corresponding Author InformationReprint requests: Hugh S. Taylor, M.D., Chief of the Division of Reproductive Endocrinology and Infertility, Professor of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510 (FAX: 203-785-7819).

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut

Received 11 August 2008; received in revised form 26 August 2008; accepted 29 August 2008. published online 20 October 2008.

Objective

To characterize human endometrial HOXA10 expression in patients using a copper intrauterine device (IUD).

Design

Case-control study.

Setting

Academic medical center.

Patient(s)

Women using copper IUDs.

Intervention(s)

Immunohistochemical analysis of endometrial HOXA10 expression in biopsy samples obtained from 24 women using a copper Paraguard T380A as well as in samples obtained from 10 normal cycling women who were not using an IUD or hormonal contraceptives.

Main Outcome Measure(s)

Endometrial HOXA10 expression.

Result(s)

Endometrial HOXA10 expression was markedly decreased in the biopsy samples obtained from women using the IUD contraceptive when compared with controls. The mean H score for endometrial stromal cell HOXA10 expression in samples obtained from women using the Paraguard IUD was 0.21 compared with 2.2 in the control endometrial biopsy samples. Endometrial glandular expression of HOXA10 was absent in all IUD users.

Conclusion(s)

Decreased endometrial HOXA10 expression was apparent in women who use a copper IUD. Expression of HOXA10 is essential for endometrial receptivity. A novel mechanism of copper IUD action involves suppression of genes required for endometrial receptivity. The dramatic decrease of endometrial HOXA10 in response to IUD use may contribute to contraceptive efficacy.

Key Words: Endometrium, implantation, contraception, IUD, HOX

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 A.M.T. has nothing to disclose. S.M.R. has nothing to disclose. X.F. has nothing to disclose. H.S.T. has nothing to disclose.

 Supported by NICHD R01 HD036678 and U54 HD052668.

PII: S0015-0282(08)03848-X

doi:10.1016/j.fertnstert.2008.08.134

Fertility and Sterility
Volume 92, Issue 6 , Pages 1820-1824, December 2009

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