I had two failed IVF attempts. I came across an article about endometrial biopsy that said the reason most IVF fails is probably that you are missing the integrins. What does this mean? How is this tested? My GYN is not quite familiar with this procedure, and it's not being done where I go for my IVF.

A.G.

Integrins are cell adhesion molecules. These molecules play a role in the attachment of the embryo to the lining of the uterus (endometrium). Some researchers think the absence of these molecules indicates a higher risk of implantation failure. Independent corroboration of this finding remains to be published.

The test for these molecules is performed by endometrial biopsy at a specific time in the menstrual cycle and is quite expensive. However, many women who test negative for this adhesion molecule produce a different result if they're being treated with the sorts of drugs normally used during an IVF cycle (a GnRH-a such as Lupron and ovulation induction injections). So, to see if there is a problem, a biopsy would need to be done in a cycle in which you received the same drug treatment as you did during your IVF cycle. But doing IVF at that time would not be advisable, as the biopsy would be needed at the same time embryos would be transferred back into the uterus. It just does not make sense to put you through another drug treatment cycle just to do the biopsy. And, even if a problem is found, there is little that can be done to improve the odds in a future cycle.

I would not be eager to attribute your IVF failure to a lack of integrin receptors. First, it is thought that the majority of failed implantations are due to embryo factors. As to factors related to the endometrium, integrins are just one possibility -- others are the immune system, infection, and blood flow within the endometrium.