Uterine natural killer cell progenitor populations predict successful implantation in women with endometriosis-associated infertility

Am J Reprod Immunol. 2018 Mar;79(3). doi: 10.1111/aji.12817. Epub 2018 Jan 30.

Abstract

Problem: Uterine natural killer (uNK) cells play a critical role early in gestation. As we previously identified altered uNK cell development in endometriosis-associated infertility, we herein sought to characterize natural killer (NK) cell profiles in endometriosis that may predict embryo implantation.

Method of study: Study participants had a surgical diagnosis of endometriosis-associated infertility. Endometrial tissue and peripheral blood were obtained from 58 women. Thirty-three patients underwent artificial reproductive technology (IVF, ICSI, or IUI) within a mean of 9.5 months of surgery. NK and hematopoietic progenitor cells from endometrium and blood were analyzed by flow cytometry. Successful implantation was defined as a positive pregnancy test.

Results: In successful implantation, populations of endometrial CD34+ hematopoietic stem cells were higher (3.97% vs 0.69%; P < .0004), and coexpression of NK cell marker CD56 was increased (81.1% vs 60.9%; P < .034) compared with patients who had failed implantation. In contrast, levels of blood NK progenitors were similar in both groups.

Conclusion: Our study revealed that uterine NK progenitor cell populations are markedly different in patients with endometriosis who proceed to successful or failed embryo implantation and may define a novel predictor of implantation success. Our findings also highlight the fundamental differences inherent in NK cell repertoires between blood and uterine compartments.

Keywords: endometriosis; hematopoietic stem cell; implantation; uterine natural killer cell.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antigens, CD34 / metabolism
  • CD56 Antigen / metabolism
  • Embryo Implantation
  • Endometriosis / diagnosis
  • Endometriosis / immunology*
  • Female
  • Hematopoietic Stem Cells / pathology*
  • Humans
  • Infertility, Female / diagnosis
  • Infertility, Female / immunology*
  • Killer Cells, Natural / pathology*
  • Lymphocyte Count
  • Organ Specificity
  • Predictive Value of Tests
  • Prognosis
  • Uterus / pathology*
  • Young Adult

Substances

  • Antigens, CD34
  • CD56 Antigen