Enhancing understanding of endometrial function in patients with PCOS: clinical and immunological insights.

IF 3.8 3区 医学 Q1 REPRODUCTIVE BIOLOGY
Yaxin Guo, Jingfei Yang, Hong Chen, Yueping Zhou, Yan Yang, Biao Wang, Luyang Zha, Dijia Bai, Wenxuan Li, Xiaojuan Tang, Zishui Fang, Fei Li, Lei Jin
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引用次数: 0

Abstract

Objective: To evaluate the pregnancy and perinatal outcomes of different phenotypes of polycystic ovary syndrome (PCOS) patients during the frozen embryo transfer (FET) cycles. Additionally, to analyze the T cell balance in the endometrium of PCOS patients and explore its relationship with various PCOS phenotypes.

Design: Retrospective cohort study.

Setting: A single academically affiliated reproductive medicine center.

Patients: 21,074 FET cycles were included and divided into two groups based on the diagnosis of PCOS. Patients with PCOS were further categorized into four phenotypic groups: PCOM + HA + OA, PCOM + HA, PCOM + OA, and HA + OA. Endometrial biopsies from 21 PCOS patients and 26 controls were obtained to analyze T cell subsets.

Methods: Pregnancy and perinatal outcomes, as well as T cell subset abundance were compared between women with and without PCOS. Multiple logistic regression models were employed to adjust for confounding factors impacting pregnancy-related outcomes. Flow cytometry was utilized to analyze the abundance of T cell subsets.

Main outcome measures: Pregnancy and perinatal outcomes were assessed. T cell subsets including CD4+CD8-T cells, CD4-CD8+T cells, Th1, Th2, Th17 and Treg cells in the endometrium were determined by flow cytometry.

Results: There was a significantly increased incidence of miscarriage, hypertensive disorders of pregnancy (HDP), preterm birth (PTB), and even fetal malformations across different phenotypes of PCOS women, especially those with the hyperandrogenic phenotype. Th1 cells decreased while Th2 cells increased significantly in the PCOS endometrium.

Conclusions: The unfavorable pregnancy and perinatal outcomes in FET cycles and T cell imbalance both suggest the endometrial dysfunction of PCOS patients, especially those with the hyperandrogenic phenotype.

增强对多囊卵巢综合征患者子宫内膜功能的认识:临床和免疫学见解。
目的:探讨不同表型多囊卵巢综合征(PCOS)患者在冷冻胚胎移植(FET)周期内的妊娠和围产期结局。分析PCOS患者子宫内膜T细胞平衡,并探讨其与PCOS各种表型的关系。设计:回顾性队列研究。环境:一个独立的学术附属生殖医学中心。患者:纳入21,074个FET周期,并根据PCOS的诊断分为两组。将PCOS患者进一步分为PCOM + HA + OA、PCOM + HA、PCOM + OA和HA + OA 4个表型组。对21例PCOS患者和26例对照者进行子宫内膜活检,分析T细胞亚群。方法:比较PCOS患者和非PCOS患者的妊娠和围产期结局以及T细胞亚群丰度。采用多元logistic回归模型对影响妊娠相关结局的混杂因素进行校正。流式细胞术用于分析T细胞亚群的丰度。主要结局指标:评估妊娠和围产期结局。采用流式细胞术检测子宫内膜内CD4+CD8-T细胞、CD4- cd8 +T细胞、Th1、Th2、Th17和Treg细胞亚群。结果:在不同表型的PCOS女性中,流产、妊娠高血压疾病(HDP)、早产(PTB)甚至胎儿畸形的发生率均显著增加,尤其是高雄激素表型的PCOS女性。PCOS子宫内膜中Th1细胞明显减少,Th2细胞明显增加。结论:FET周期妊娠及围产期结局不利,T细胞失衡均提示PCOS患者,尤其是高雄激素表型PCOS患者存在子宫内膜功能障碍。
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来源期刊
Journal of Ovarian Research
Journal of Ovarian Research REPRODUCTIVE BIOLOGY-
CiteScore
6.20
自引率
2.50%
发文量
125
审稿时长
>12 weeks
期刊介绍: Journal of Ovarian Research is an open access, peer reviewed, online journal that aims to provide a forum for high-quality basic and clinical research on ovarian function, abnormalities, and cancer. The journal focuses on research that provides new insights into ovarian functions as well as prevention and treatment of diseases afflicting the organ. Topical areas include, but are not restricted to: Ovary development, hormone secretion and regulation Follicle growth and ovulation Infertility and Polycystic ovarian syndrome Regulation of pituitary and other biological functions by ovarian hormones Ovarian cancer, its prevention, diagnosis and treatment Drug development and screening Role of stem cells in ovary development and function.
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