Leukemia inhibitory factor is dysregulated in the endometrium and uterine flushing fluid of patients with adenomyosis during implantation window

Objective To determine whether the expression of leukemia inhibitory factor during the implantation window in endometrial tissue and uterine flushing fluid of patients with adenomyosis differs from that of healthy fertile women. Design Experimental study using endometrial tissue and uterine flushing fluid. Setting Peking University First Hospital, People's Republic of China. Patient(s) There were 28 patients with adenomyosis and 27 control fertile women. Intervention(s) Uterine flushing fluid and endometrial samples were collected during the implantation window, defined as 7 to 9 days after ovulation. Main Outcome Measure(s) Leukemia inhibitory factor levels in uterine flushing fluid were measured by enzyme-linked immunosorbent assay. Leukemia inhibitory factor messenger RNA expression in eutopic endometrium was quantified by real-time reverse transcriptase polymerase chain reaction. Leukemia inhibitory factor protein expression was evaluated with semiquantitative immunohistochemistry. Result(s) Leukemia inhibitory factor levels were significantly lower in the uterine flushing fluid of patients with adenomyosis with a history of infertility. Leukemia inhibitory factor messenger RNA and protein also were significantly lower in patients with adenomyosis, compared with control. Leukemia inhibitory factor immunostaining intensity was significantly lower in patients with adenomyosis, compared with control. Conclusion(s) Leukemia inhibitory factor is dysregulated in the endometrium and uterine flushing fluid of women with adenomyosis during the implantation window.