Are Uterine Natural Killer and Plasma Cells in Infertility Patients Associated with Endometriosis, Repeated Implantation Failure, or Recurrent Pregnancy Loss?

Overview

Journal Arch Gynecol Obstet

Specialty Gynecology & Obstetrics

Date 2020 Jul 16

PMID 32666129

Citations 19

Authors

Nadine Freitag

Sarah J Pour

Tanja N Fehm

Bettina Toth

Udo R Markert

Maja Weber

Riku Togawa

Jan-Steffen Kruessel

Dunja M Baston-Buest

Alexandra P Bielfeld

Affiliations

Soon will be listed here.

Abstract

Purpose: Infertility is a debilitating situation that millions of women around the world suffer from, but the causal relationship between infertility and endometriosis is still unclear. We hypothesize that the immune cell populations of uterine natural killer cells (uNK) and plasma cells (PC) which define chronic endometritis could differ in patients with or without endometriosis and therefore be the link to endometriosis-associated infertility.

Methods: Our retrospective study includes 173 patients that underwent an endometrial scratching in the secretory phase of the menstrual cycle and subsequently immunohistochemical examination for uNK cells and PC. Sixty-seven patients were diagnosed with endometriosis, 106 served as the control cohort.

Results: The risk for an elevated number of uNK cells in women with endometriosis is not increased as compared to the control group. Our findings suggest that patients with endometriosis are 1.3 times more likely to have chronic endometritis (CE) as compared to those without and that the treatment with doxycycline might increase pregnancy rates. Endometriosis and an increased number of uNK cells seem to be unrelated.

Conclusions: In contrast to the lately published connection between endometriosis, infertility and increased uNK cells, we could not find any evidence that patients with endometriosis are more prone to elevated uterine uNK cells. Counting of PC in endometrial biopsies might be a new approach in the search of biomarkers for the nonsurgical diagnosis of endometriosis since our findings suggest a connection.

Citing Articles

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Chronic Endometritis and Endometriosis: Two Sides of the Same Coin?.

Kalaitzopoulos D, Catena U, Schwarzt A, Schwartz A, Schoretsanitis G, Leeners B Reprod Sci. 2025; 32(2):474-487.

PMID: 39821822 DOI: 10.1007/s43032-025-01785-y.

Plasma Cells as the Key Players of IVF Failure? Unlocking the Enigma of Infertility and In Vitro Fertilization Failure in the Light of Uterine Inflammation.

Dwojak E, Mroczek M, Dworacki G, Dobosz P, Slubowska A, Stepien M Int J Mol Sci. 2024; 25(23).

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How does chronic endometritis influence pregnancy outcomes in endometriosis associated infertility? A retrospective cohort study.

Lin S, Xie X, Chen Y, Wang Z, Zhang J, Liu C Reprod Health. 2024; 21(1):162.

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Bridging the Diagnostic Gap between Histopathologic and Hysteroscopic Chronic Endometritis with Deep Learning Models.

Kitaya K, Yasuo T, Yamaguchi T Medicina (Kaunas). 2024; 60(6).

PMID: 38929589 PMC: 11205857. DOI: 10.3390/medicina60060972.

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