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

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 v...

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Main Authors: 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
Format: Article
Language:English
Published: BMC 2025-03-01
Series:Journal of Ovarian Research
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Online Access:https://doi.org/10.1186/s13048-025-01638-x
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author 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
author_facet 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
author_sort Yaxin Guo
collection DOAJ
description 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.
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publishDate 2025-03-01
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spelling doaj-art-556b439178064b729eca3a0835c882022025-08-20T02:56:20ZengBMCJournal of Ovarian Research1757-22152025-03-0118111410.1186/s13048-025-01638-xEnhancing understanding of endometrial function in patients with PCOS: clinical and immunological insightsYaxin Guo0Jingfei Yang1Hong Chen2Yueping Zhou3Yan Yang4Biao Wang5Luyang Zha6Dijia Bai7Wenxuan Li8Xiaojuan Tang9Zishui Fang10Fei Li11Lei Jin12Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyReproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyReproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyState Key Laboratory of Material Processing and Die & Mould Technology, Huazhong University of Science and TechnologyCollege of Life Science, Shaanxi Normal UniversityReproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyReproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyReproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyReproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Urology, Peking University First HospitalReproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyReproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract 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.https://doi.org/10.1186/s13048-025-01638-xPolycystic ovary syndromeMiscarriageHypertensive disorders of pregnancyPreterm birthT cells
spellingShingle 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
Enhancing understanding of endometrial function in patients with PCOS: clinical and immunological insights
Journal of Ovarian Research
Polycystic ovary syndrome
Miscarriage
Hypertensive disorders of pregnancy
Preterm birth
T cells
title Enhancing understanding of endometrial function in patients with PCOS: clinical and immunological insights
title_full Enhancing understanding of endometrial function in patients with PCOS: clinical and immunological insights
title_fullStr Enhancing understanding of endometrial function in patients with PCOS: clinical and immunological insights
title_full_unstemmed Enhancing understanding of endometrial function in patients with PCOS: clinical and immunological insights
title_short Enhancing understanding of endometrial function in patients with PCOS: clinical and immunological insights
title_sort enhancing understanding of endometrial function in patients with pcos clinical and immunological insights
topic Polycystic ovary syndrome
Miscarriage
Hypertensive disorders of pregnancy
Preterm birth
T cells
url https://doi.org/10.1186/s13048-025-01638-x
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