Correlation between Integrin Alpha v Beta3 Expression, Endometrial Thickness and Sub- Endometrial Blood Flow Resistance Index in Unexplained Infertility; Case Control Study

Infertility that cannot be explained by anovulation, poor sperm quality, tubal disease, or any other recognized cause of infertility is referred to as unexplained infertility. The aim of this study is to assess the correlation between integrin alpha-v beta-3 expression, endometrial thickness and subendometrial blood flow resistance index in unexplained infertility.

The study carried out on Kamal – Al-Samurai fertility center in the period from October 2020 - September 2021. Six days after detecting urinary Luteinizing Hormone (LH) surge, all the women were asked to come to do two-dimensional (2D) transvaginal ultrasound to assess endometrial thickness and subendometrial blood flow color Doppler resistance index and endometrial samples was taken and examined immunohistochemically to detect alpha-v beta-3 integrin. The cut-off value of integrin and subendometrial blood flow resistance index, sensitivity and specificity were calculated by applying Receiver Operative Characteristics (ROC) curve.

The endometrial thickness was lower and resistance index was higher in case group (P < 0.001). The expression of integrin alpha-v beta-3 in infertile group was significantly low (P < 0.001) with significant positive correlation between integrin score and endometrial thickness (r= -0.708 & P < 0.001) and significant negative correlation between integrin score and subendometrial resistance index (r= -0.786 & P <0.001).

Alpha-v beta-3 integrin expressions and endometrial thickness are reduced significantly in mid-luteal phase while the subendometrial blood flow color Doppler resistant index significantly increased, and using them together can possibly be used as a diagnostic predictor of unexplained infertility.