Abstract

Objective: To investigate the role and mechanisms by which macrophages (MΦ) contribute to the immune environment of the endometrium in cases of recurrent implantation failure (RIF). Methods: Endometrial transcriptome data from women with and without RIF (control group) were collected. The CIBERSORT software was used to determine the abundance of immune cells within the endometrial tissue based on expression profiles. Weighted gene co-expression network analysis was used to identify crucial regulatory genes and pathways. Results: Application of CIBERSORT confirmed significant infiltration of macrophages in the RIF group. SOX6, TTC21A, KLHL31, NFIA, TNNT1, TPM1, CPVL, FUS, PEX5, and SLC43A3 were all closely correlated with M2 and M0 macrophages. Metascape and DisNor analyses revealed that these genes contribute to the regulation of macrophage polarization via the Wnt signaling pathway. Conclusion: This study identified dysregulation of macrophage polarization within the immune microenvironment of the endometrium in patients with RIF. A comprehensive analysis was conducted to investigate the potential mechanisms underlying this disorder. Dysregulation of macrophage polarization in the endometrium of patients with RIF is strongly associated with the Wnt signaling pathway.

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