Gene Expression Levels of CSF-1 and CSF-1R Endometrial under The Influence of Prolactin Level in Unexplained Miscarriage: A Case-Control Study

Hormones such as prolactin, by influencing expression of the endometrial genes, play a pivotalrole in embryo implantation and development. The present study aimed to evaluate serum level of prolactin andits effect on altering expression level of colony-stimulating factor-1 (CSF-1) and colony-stimulating factor-1 receptor(CSF-1R) genes in endometrial tissue during in vitro fertilization (IVF) pregnancy in the infertile womenand recurrent pregnancy loss (RPL), compared to fertile women, who lost their pregnancies at gestational age<20 weeks. In this case-control study, 40 infertile women, 40 IVF pregnant women with RPL and 40fertile women who lost their pregnancies at <20 weeks of gestation for unknown reasons were selected. Prolactinserum level was assessed using ELISA technique and expression of CSF-1 and CSF-1R genes was determined inendometrial tissue, using quantitative reverse transcription polymerase chain reaction (qRT-PCR). Mean prolactin level of the infertile group was 24.38 ± 1.43 ng/mL and it had statistically significantrelationship with the fertile group (P<0.001). Expression level of the CSF-1 and CSF-1R genes were higher in thefertile than infertile groups by 2.88 times (P<0.0001) and 2.64 times (P<0.0001), while it was respectively 2.28(P<0.0001) and 1.69 (P<0.0001) times higher compared to the RPL group. Risk factors for pregnancy loss, suchas aging, increased body mass index (BMI), smoking and diabetes caused decreasing changes in gene expression(CSF-1 and CSF-1R) and the differences were statistically significant, except in the infertile group. The present study showed a significant relationship of CSF-1 and CSF-1R expression levels with pregnancyloss. Risk factors such as aging, obesity, smoking and diabetes decreased both genes expression levels.