Morphological events in the primate endometrium in the presence of a preimplantation embryo, detected by the serum preimplantation factor bioassay.

BACKGROUND Hormonal modulation of the endometrium towards receptivity is well established; however, the role of embryonic stimuli in modulation of the endometrium prior to implantation, especially in primates, is unknown. The aim of the present study was to evaluate the endometrial histology when the embryo was present in its vicinity prior to implantation. METHODS Preimplantation factor (PIF) bioassay was used as a tool to detect the presence of an embryo in the uterine lumen of mated bonnet monkeys (Macaca radiata) (n=9). The control group comprised seven non-mated animals. The specificity of the PIF bioassay for the presence of an embryo was tested by studies in pregnant humans and monkeys. The effects of embryonic stimuli on the endometrial morphology were analysed by routine haematoxylin-eosin staining. The expressions of CD34, an endothelial cell marker, alpha-smooth muscle actin (alpha-SMA), a marker for blood vessel maturation, and prolactin, a marker of endometrial decidualization, were studied by immunohistochemistry. RESULTS That PIF is embryo specific was established by its presence in sera of pregnant humans, monkeys and also in embryo culture media. Six mated bonnet monkeys were found to be PIF positive. Morphologically, the endometria from these PIF-positive animals showed the presence of the pre-epithelial plaque reaction, increased angiogenesis and stromal compaction. The significantly increased number of CD34- and alpha-SMA-positive blood vessels (P<0.05) in the endometria of PIF-positive animals indicated increased angiogenesis in response to embryonic stimuli. The endometrial expression of immunoreactive prolactin was also significantly increased (P<0.05) in the PIF-positive animals, indicating decidualization. CONCLUSIONS Using PIF as a marker to detect early pregnancy in bonnet monkeys, we have shown that the embryo induces a pre-epithelial plaque type of reaction, increased angiogenesis and decidual reaction in the endometrium prior to implantation.