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Abstract
To characterize human endometrial HOXA10 expression in patients using a copper intrauterine
device (IUD).
Case-control study.
Academic medical center.
Women using copper IUDs.
Immunohistochemical analysis of endometrial HOXA10 expression in biopsy samples obtained
from 24 women using a copper Paraguard T380A as well as in samples obtained from 10
normal cycling women who were not using an IUD or hormonal contraceptives.
Endometrial HOXA10 expression.
Endometrial HOXA10 expression was markedly decreased in the biopsy samples obtained
from women using the IUD contraceptive when compared with controls. The mean H score
for endometrial stromal cell HOXA10 expression in samples obtained from women using
the Paraguard IUD was 0.21 compared with 2.2 in the control endometrial biopsy samples.
Endometrial glandular expression of HOXA10 was absent in all IUD users.
Decreased endometrial HOXA10 expression was apparent in women who use a copper IUD.
Expression of HOXA10 is essential for endometrial receptivity. A novel mechanism of
copper IUD action involves suppression of genes required for endometrial receptivity.
The dramatic decrease of endometrial HOXA10 in response to IUD use may contribute
to contraceptive efficacy.