endometrial tnf-α, caspase-9, hsp70, and lif expression in hydrosalpinx: implications for implantation failure

Background & objective: hydrosalpinx has been associated with impaired endometrial receptivity and reduced fertility. this study was conducted with aim to examine the expression of tumour necrosis factor-alpha (tnf-α), caspase-9, heat shock protein 70 (hsp70), and leukaemia inhibitory factor (lif) in the endometrium of women with and without hydrosalpinx.materials & methods: this cross-sectional study was conducted between may and june 2017 across three referral hospitals. a total of 48 reproductive-aged women undergoing endometrial biopsy were enrolled and equally divided into two groups: those diagnosed with hydrosalpinx and healthy controls. immunohistochemical staining was used to assess the expression of tnf-α, caspase-9, hsp70, and lif. semi-quantitative analysis was performed using histoscore evaluation of staining intensity and distribution.results: the hydrosalpinx group compared to the control group significantly exhibited higher expression of tnf-α (median 12 vs. 9) and caspase-9 (12 vs. 8.5), and lower expression of hsp70 (6 vs. 8) and lif (9 vs. 12) (p<0.001 for tnf-α, caspase-9, and hsp70; p<0.05 for lif, respectively).conclusion: hydrosalpinx is associated with altered expression of inflammatory and apoptotic markers in the endometrium, including elevated tnf-α and caspase-9 and reduced hsp70 and lif. these molecular disruptions may impair endometrial receptivity and contribute to infertility, highlighting potential targets for therapeutic intervention.