Department of Obstetrics, Gynecology and REI (UniKiD), Medical Faculty, Medical Center University of Düsseldorf, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
Department of Obstetrics and Gynecology, Medical Center University of Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
Arch Gynecol Obstet. 2020 Dec;302(6):1487-1494. doi: 10.1007/s00404-020-05679-z. Epub 2020 Jul 14.
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.
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.
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.
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.
不孕症是全球数百万妇女所面临的一种使人衰弱的情况，但不孕症和子宫内膜异位症之间的因果关系仍不清楚。我们假设，定义慢性子宫内膜炎的子宫自然杀伤细胞（uNK）和浆细胞（PC）的免疫细胞群体在患有或不患有子宫内膜异位症的患者中可能不同，因此可能是与子宫内膜异位症相关的不孕症的联系。
我们的回顾性研究包括 173 名在月经周期分泌期进行子宫内膜刮除术的患者，随后对 uNK 细胞和 PC 进行免疫组织化学检查。67 名患者被诊断为子宫内膜异位症，106 名作为对照组。
与对照组相比，患有子宫内膜异位症的女性 uNK 细胞数量升高的风险没有增加。我们的研究结果表明，与无子宫内膜异位症的患者相比，患有子宫内膜异位症的患者发生慢性子宫内膜炎（CE）的可能性增加 1.3 倍，并且使用强力霉素治疗可能会增加怀孕率。子宫内膜异位症和 uNK 细胞数量增加似乎没有关系。
与最近发表的关于子宫内膜异位症、不孕症和 uNK 细胞增加之间的联系相反，我们没有发现任何证据表明患有子宫内膜异位症的患者更容易出现升高的子宫 uNK 细胞。计数子宫内膜活检中的 PC 可能是寻找非手术诊断子宫内膜异位症的生物标志物的新方法，因为我们的研究结果表明存在联系。
