Altered eutopic endometrial T-regulatory and T-helper 17 lymphocyte ratio in women with unexplained subfertility

Malavika K. Adur, Andrea G. Braundmeier-Fleming, Bruce A. Lessey, Romana A. Nowak

Research output: Contribution to journalArticlepeer-review


Problem: Perturbations in T-helper lymphocyte profiles have previously been associated with endometriosis related subfertility and conception failure. Hence a retrospective in vitro study was conducted to evaluate the relationship between T-regulatory (Treg) and T-helper 17 (Th17) lymphocytes in the eutopic endometrium of women with unexplained subfertility and correlate these profiles to their conception status. Method of study: Eutopic endometrial biopsies were collected during the mid-secretory phase of the menstrual cycle, from women with unexplained subfertility. These samples were evaluated immunohistochemically for Treg and Th17 lymphocytes as well as the related proinflammatory cytokine, Interleukin-17 (IL-17). These eutopic endometrial T lymphocyte subpopulations were compared to the patients’ conception status in subsequent cycles. Results: Though Treg cells were not indicative of conception success in subsequent cycles, patients who maintained their subfertile (no conception) status were observed to have a higher Th17 cell count in their eutopic endometrium. The ratio of Treg:Th17 cell counts was significantly correlated to patient conception status as well. These trends stayed consistent irrespective of concurrent endometriosis. Conclusion: Patients with a high proinflammatory Th17 lymphocyte profile and low Treg:Th17 ratio in their eutopic endometrium during the secretory phase of their menstrual cycle are more likely to not conceive in subsequent cycles.

Original languageEnglish (US)
Pages (from-to)185-194
Number of pages10
JournalJournal of Endometriosis and Pelvic Pain Disorders
Issue number3
StatePublished - Sep 2021


  • Interleukin 17
  • T-regulatory lymphocytes
  • Th17 lymphocytes
  • Unexplained subfertility
  • endometriosis

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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