Embryo Condition Media Collected from Polycystic Ovary Syndrome Patients with Abdominal Obesity Can Increase The Decidualization Potential of Healthy Endometrial Stromal Cells

Polycystic ovary syndrome (PCOS) is a common endocrinological disorder associated with abdominalobesity (AO) and some reproductive complications including low pregnancy rate. Embryo-endometrium cross-talkhas a key role in successful embryo implantation and subsequent normal pregnancy rate. The primary objective ofthis study is to evaluate the decidualization potential of endometrial stromal cells (ESCs) using the embryo conditionmedia (ECM) collected from PCOS patients with AO, compared to ECM of those patients without AO. In this experimental study, we measured the capacity of ECM collected from PCOS patientswith or without AO for decidualization induction in healthy ESCs after coculture. A total number of 53 embryos from40 couples belonging to PCOS with AO, PCOS without AO, nonPCOS with AO, and nonPCOS without AO patients,were included in our study. The embryosof four groups were single-cultured up to the blastocyst stage. Their ECM(45λ/well) were pooled and added to healthy ESCs monolayer culture media to investigate their effects on decidualizationpotential via gene (PRL, IGFBP1, IL1-β, HOXA10, IL-6 and TNF-α) and protein (PRL, IGFBP1, IL1-β)expression analysis and ESCs migration assay. The morphological analysis, migration assay (P≤0.0321), protein (P≤0.0139) and gene expression analysisshowed PCOS with AO accounted for the highest gene (PRL, IGFBP1, IL1-β, HOXA10, IL-6, TNF-α) and proteinmarkers (PRL, IGFBP1, IL1-β) (P≤0.05). NonPCOS individuals without AO had the lowest level of both gene andprotein decidualization markers (P≤0.05). Considering decidualization as an inflammatory process, a higher level of decidualization markers wasassociated with a higher inflammatory status created by AO and PCOS, separately. Inflammation may disrupt the processof inflammatory to anti-inflammatory phase required for prevention of pregnancy loss, this could explain the highrate of abortion in these cases.