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The role of endometrial staining for CD138 as a marker of chronic endometritis in predicting live birth

  • Reproductive Physiology and Disease
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

Chronic endometritis (CE) is diagnosed via endometrial biopsy and staining for plasma cells. A threshold plasma cell count that identifies CE and predicts pregnancy outcomes has not been established, and the prevalence of plasma cells in the general infertile population is unknown. The purpose of this study was to determine the prevalence of plasma cells in the general infertile population and whether a threshold exists which predicts live birth.

Methods

Endometrial samples were obtained prospectively from 80 women undergoing IVF, embedded in paraffin, and stained for plasma cells using mouse mono-clonal antibody for CD138. Slides were reviewed at 20× magnification and 10 random images captured. Three reviewers graded each image for plasma cells. Participants underwent single, euploid, and frozen blastocyst transfer.

Results

Forty-nine percent of samples had ≥1 plasma cell across 10 HPFs, 11% had ≥5 cells across 10 HPFs, and 4% had ≥10 cells across 10 HPFs. There was no difference in prevalence between those who did and did not achieve live birth. Using thresholds of 1, 5, and 10 plasma cells per 10 HPFs, there were no differences in implantation, clinical pregnancy, clinical pregnancy loss, or live birth rates between patients with and without CE.

Conclusion

Endometrial plasma cells are present in half the general infertile population and do not predict implantation, clinical pregnancy, clinical pregnancy loss, or live birth rates at low levels.

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Data availability

The data underlying this article cannot be shared publicly in order to protect the privacy of the individuals who participated in the study. The data will be shared on reasonable request to the corresponding author.

Code availability

Not applicable.

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Author information

Authors and Affiliations

  1. IVI/RMA New Jersey, Basking Ridge, NJ, USA

    N. S. Herlihy, A. M. Klimczak, C. Scott, B. M. Hanson, J. K. Kim, E. Seli & R. T. Scott

  2. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

    N. S. Herlihy, A. M. Klimczak, B. M. Hanson, J. K. Kim & R. T. Scott

  3. Foundation for Embryonic Competence, Basking Ridge, NJ, USA

    S. Titus

  4. Yale Medical School, New Haven, CT, USA

    E. Seli

Authors
  1. N. S. Herlihy
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  2. A. M. Klimczak
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  3. S. Titus
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  4. C. Scott
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  5. B. M. Hanson
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  6. J. K. Kim
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  7. E. Seli
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  8. R. T. Scott
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Contributions

All authors listed on this manuscript contributed meaningfully to the conception of the study, data acquisition, and writing of the final manuscript. All authors approved of the final manuscript prior to submission.

Corresponding author

Correspondence to N. S. Herlihy.

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Ethics approval

Institutional Review Board approval was obtained for the study from Western IRB (Protocol RMA-2018-01).

Consent to participate

Informed consent was obtained from all individuals participants included in the study.

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Patients signed informed consent regarding publishing their data.

Conflict of interest

The authors declare no competing interests.

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Herlihy, N.S., Klimczak, A.M., Titus, S. et al. The role of endometrial staining for CD138 as a marker of chronic endometritis in predicting live birth. J Assist Reprod Genet 39, 473–479 (2022). https://doi.org/10.1007/s10815-021-02374-z

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  • DOI: https://doi.org/10.1007/s10815-021-02374-z

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