Impact of soluble HLA-G levels and endometrial NK cells in uterine flushing samples from primary and secondary unexplained infertile women.

Roberta Rizzo,Daria Bortolotti,Angela Graziano,Valentina Gentili,Roberto Marci,Dario Di Luca,Giuseppe Lo Monte

doi:10.3390/ijms16035510

Roberta Rizzo, Daria Bortolotti + Show 5 more

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https://doi.org/10.3390/ijms16035510

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Abstract

The aim of this research was to determine the levels of human leukocyte antigen G (HLA-G) and endometrial Natural Killer ((e)NK) cell percentages in uterine flushing samples from primary and secondary infertile women. sHLA-G levels were lower in the uterine flushing samples from primary infertile women in comparison with women with secondary infertility. Lower CD56+KIR2DL4+ (e)NK cell percentages were detected in primary infertile women compared with secondary infertile women. This is the first study demonstrating that primary and secondary unexplained infertilities are characterized by different basal sHLA-G levels and CD56+KIR2DL4+ (e)NK cell percentages.

Highlights

A complex, highly coordinated sequence of structural and biochemical changes culminate in the generation of a “window” of uterine receptivity during the mid-luteal phase of each menstrual cycle.Compromised receptivity of the endometrium is believed to be a primary cause of unexplained infertility characterized by implantation failure and subclinical pregnancy loss
We evaluated the role of sHLA-G in uterine flushing from women affected by primary or secondary infertility and the possible correlation with (e)Natural Killer (NK) presence
We observed no correlation between Thyroid-stimulating hormone (TSH) levels and the condition of primary or secondary infertility (r = −0.212; p = 0.252; Spearman correlation test)

Summary

Introduction

A complex, highly coordinated sequence of structural and biochemical changes culminate in the generation of a “window” of uterine receptivity during the mid-luteal phase of each menstrual cycle. Compromised receptivity of the endometrium is believed to be a primary cause of unexplained infertility characterized by implantation failure and subclinical pregnancy loss. In women, unexplained infertility has been associated with a range of cellular and molecular defects of the endometrium and immunological factors. Since the fetus is semi-allogenic respect to the mother, the maternal immune-modulation is crucial in protecting the fetus. Natural Killer (NK) cells are the dominant immune cell type in the endometrium and play a major role in determining pregnancy outcome [1]. Human decidual (d)NK cells are a distinct

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