Hysteroscopic polypectomy decreases NF-κB1 expression in the mid-secretory endometrium of women with endometrial polyp.

OBJECTIVES: Endometrial polyps have been identified as a possible factor for sub-fertility, their implication on endometrial NF-κB1 activity; the central regulator of the immune system gene expression involved in implantation has yet been little studied. We evaluated the NF-κB1 level and NF-κB p65 expression in the endometrium before and after hysteroscopic removal of the endometrial polyp during the mid-secretory phase.

STUDY DESIGN: Infertile women with polyp (n=15) were enrolled. Unexplained infertile patients with normal endometrium (n=5) and healthy fertile women (n=5) were recruited as controls. Endometrial samples were obtained before and 4 months after the hysteroscopic polypectomy. NF-κB1 levels were analyzed by ELISA in the endometrium of all groups before and after polypectomy. The H-Score method was used to evaluate immunohistochemical NF-κB p65 expression in the endometrium.

RESULTS: NF-κB1 expression and NF-κB p65 immunoreactivity in the endometrium were significantly higher in women with polyp compared to unexplained infertile and fertile controls. Hysteroscopic polypectomy resulted in a significant decrease in endometrium NF-κB1 and NF-κB p65 activity.

CONCLUSIONS: Endometrium of women with endometrial polyp has abnormalities in expression of NF-κB1 and NF-κB p65 which may contribute to endometrial receptivity and so polyp related sub-fertility. Hysteroscopic polypectomy may help to the normalization of endometrial NF-κB concentrations.