Investigators: A/Prof Beverley Vollenhoven (2) A/Prof Caroline Gargett (1), Germana Ryan (1), A/ Prof Luk Rombauts (2,3), Dr Gareth Weston (2,3)
1 Hudson Institute of Medical Research, Clayton; 2 Monash IVF, Clayton; 3 Monash Dept Obstetrics and Gynaecology, Clayton
Recent studies show that biopsy-induced endometrial injury in the cycle prior to embryo transfer (ET) doubles live birth rates from IVF procedures. A Cochrane Systematic Review confirmed the safety and effectiveness of endometrial biopsy for improving ART outcomes. We propose that endometrial injury activates endometrial stem/progenitor cells, improving endometrial quality and promoting embryo implantation. Using our novel markers of human endometrial mesenchymal stem cells (W5C5) and epithelial progenitors (CDH2), we present pilot data showing a significant relationship between endometrial stem/progenitor cell profiles (W5C5hiCDH2lo) and pregnancy outcome in a cohort of 18 women undergoing IVF-ET. This observational study aims to increase this cohort to adequately power the study to quantify the number of W5C5 and CDH2 cells in endometrial biopsies obtained from infertile women, and determine their relationship with clinical pregnancy/live birth rates and endometrial thickness. We will obtain biopsies in the cycle before ET, dissociate endometrial tissue to single cells and use flow cytometry to quantify the adult stem cells expressing our specific surface markers. This study will suggest a novel mechanism to explain increased pregnancy rates observed with endometrial injury/“scratching” and provide the first data linking this observation with endometrial stem/progenitor cells in tissue. It will increase our understanding of how a thick receptive endometrium can be generated for IVF-ET protocols to significantly improve ART outcomes.