Menstrual flow as a non-invasive source of endometrial organoids

Tereza Cindrová‐Davies, Xiaohui Zhao, Kay Elder, Carolyn Jones, Ashley Moffett, Graham J Burton, Margherita Y. Turco
Communications biology · 2021 · vol. 4(1) · doi:10.1038/s42003-021-02194-y · PMID:34140633 · PMC8211845 · W3166332074
article OA: gold CC0 ⤵ 22 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Researchers derived endometrial organoids from menstrual flow, demonstrating they accurately reflect in vivo endometrial tissue and respond to hormones, offering a non-invasive alternative to biopsies.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

The paper studied whether endometrial organoids can be derived non-invasively from menstrual flow, using an experimental design where women undergoing an endometrial scratch as part of IVF provided paired menstrual flow samples from the same cycle. Organoids derived from menstrual gland fragments showed an ~87% derivation success rate, formed with similar efficiency and proliferation to organoids from scratch biopsies, and produced organoid morphologies indistinguishable morphologically. RNA-seq demonstrated that menstrual-flow and scratch-derived organoids clustered together and shared conserved transcriptomic signatures, and both responded similarly to sex steroids and early-pregnancy hormones by altering marker expression and secretory outputs such as glycodelin. A key limitation explicitly noted is that failed derivations were associated with dead starting cells and were not further explored. This paper is centrally about endometriosis—noninvasive endometrial organoid generation is positioned as a tool for investigating endometriosis among other gynecological conditions.

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Abstract

Abstract Assessment of the endometrium often necessitates a biopsy, which currently involves an invasive, transcervical procedure. Here, we present an alternative technique based on deriving organoids from menstrual flow. We demonstrate that organoids can be derived from gland fragments recovered from menstrual flow. To confirm they faithfully reflect the in vivo state we compared organoids derived from paired scratch biopsies and ensuing menstrual flow from patients undergoing in vitro fertilisation (IVF). We demonstrate that the two sets of organoids share the same transcriptome signature, derivation efficiency and proliferation rate. Furthermore, they respond similarly to sex steroids and early-pregnancy hormones, with changes in morphology, receptor expression, and production of ‘uterine milk’ proteins that mimic those during the late-secretory phase and early pregnancy. This technique has wide-ranging impact for non-invasive investigation and personalised approaches to treatment of common gynaecological conditions, such as endometriosis, and reproductive disorders, including failed implantation after IVF and recurrent miscarriage.

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Condition tags

endometriosis

MeSH descriptors

Endometrium Menstruation Organoids Adult Cells, Cultured Endometrium Endometrium Endometrium Female Fertilization in Vitro Humans Organoids Organoids Organoids Pilot Projects

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