Altered eutopic endometrial T-regulatory and T-helper 17 lymphocyte ratio in women with unexplained subfertility

Malavika K Adur, Andrea Braundmeier‐Fleming, Andrea G Braundmeier-Fleming, Bruce A Lessey, Romana A. Nowak
Journal of endometriosis and pelvic pain disorders · 2021 · vol. 13(3) , pp. 185–194 · doi:10.1177/22840265211018544 · PMID:34354965 · PMC8330881 · W3172079410
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

Women with unexplained subfertility and a higher count of Th17 cells, resulting in a lower Treg:Th17 ratio in their eutopic endometrium, were less likely to conceive in subsequent cycles.

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Abstract

PROBLEM: Perturbations in T-helper lymphocyte profiles have previously been associated with endometriosis related subfertility and conception failure. Hence a retrospective in vitro study was conducted to evaluate the relationship between T-regulatory (Treg) and T-helper 17 (Th17) lymphocytes in the eutopic endometrium of women with unexplained subfertility and correlate these profiles to their conception status. METHOD OF STUDY: Eutopic endometrial biopsies were collected during the mid-secretory phase of the menstrual cycle, from women with unexplained subfertility. These samples were evaluated immunohistochemically for Treg and Th17 lymphocytes as well as the related proinflammatory cytokine, Interleukin-17 (IL-17). These eutopic endometrial T lymphocyte subpopulations were compared to the patients' conception status in subsequent cycles. RESULTS: Though Treg cells were not indicative of conception success in subsequent cycles, patients who maintained their subfertile (no conception) status were observed to have a higher Th17 cell count in their eutopic endometrium. The ratio of Treg:Th17 cell counts was significantly correlated to patient conception status as well. These trends stayed consistent irrespective of concurrent endometriosis. CONCLUSION: Patients with a high proinflammatory Th17 lymphocyte profile and low Treg:Th17 ratio in their eutopic endometrium during the secretory phase of their menstrual cycle are more likely to not conceive in subsequent cycles.

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endometriosis

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