فهرست نشریات علمی دسترسی آزاد ایران

Background: Defects in endometrial receptivity are significant factors in infertility and recurrent implantationfailure (RIF) during in vitro fertilization (IVF). This study aimed to evaluate the expression levels ofsteroid hormone receptors and circulating biomarkers in women with RIF compared to fertile controls.Materials and Methods: This case-control study was conducted in Tehran from June 2021 to December 2023,involving 50 fertile women as controls and 50 women with unexplained RIF referred to the RIF Medical Center atArash Hospital. Blood samples and endometrial biopsies were collected at the day of the LH surge was LH 0. Theexpression levels of estrogen receptors (ESR-α and ESR-β) and progesterone receptor B (PGR-B) in endometrialtissue were assessed using real-time polymerase chain reaction (RT-PCR). Serum levels of estrogen were measuredby enzyme-linked immunosorbent assay (ELISA).Results: Women with RIF exhibited significantly higher ESR-α expression and lower ESR-β and PGR-B expressioncompared to fertile women (P<0.001). A positive correlation was found between ESR-α gene expression andhs-CRP levels, while ESR-β and PGR-B were associated with AMH concentrations. RIF patients showed lowerserum levels of AMH and Vit-D3, but elevated hs-CRP. Fertile women demonstrated a positive association betweenPGR-B expression and Vit-D3 levels. The ROC curve analysis revealed high discrimination power for the expressionof ESR-α (AUC 1.00), ESR-β (0.988), and PGR-B (0.898).Conclusion: The study links endometrial PGR-B expression and vitamin D3 levels to decidualization and inflammationregulation. It suggests that infertility in women with RIF may stem from elevated ESR-α, increased inflammation,and reduced ESR-β and PGR-B expression. Further research is needed on PGR-B, VDR gene expression,and fertility biomarkers. ROC analysis indicates that endometrial steroid receptor expression, AMH, and vitaminD3 levels could aid in diagnosing RIF.