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Title: Endometrial leucocytes and their relation to fertility
Author: Stewart, Jane A.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2001
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The aims of these studies were to establish further knowledge of the endometrial cyclical immune response and its controls and to relate this to previous pregnancy and in particular unexplained sub-fertility. In addition the possibility of examining the direct effect of early embryo products on individual endometrial leucocyte populations in vitro has been explored. The clinical aspects of this work were performed in the Centre for Reproductive Medicine, Royal Victoria Infirmary, Newcastle-upon-Tyne and laboratory work was performed in the Departments of Pathology and Immunology. For the majority of these studies subjects were recruited into one of four groups; parous fertile, parous infertile, nulliparous, presumed fertile and nulliparous infertile. Timed endometrial biopsies were obtained at 7 and 13 days following the urinary luteinising hormone surge in separate cycles from these subjects. Further studies were performed using endometrial biopsies obtained from hysterectomy specimens and decidua from first trimester terminations of pregnancy. Endometrial leucocyte populations; their distributions and characteristics and their endometrial milieu were examined primarily using double and single labelling immunohistochemical techniques. This work has shown that there are significant differences in the leucocyte populations of infertile compared with fertile endometrium. In particular CD56-positive endometrial granulated lymphocytes are present in significantly greater numbers in the early secretory phase in infertile endometrium but undergo a smaller increase in numbers of the cycle proceeds. In addition a different balance of T-helper and cytotoxic T cells in infertile versus fertile endometrium at both sample times has been seen. It has also been shown in this study, that there can be no direct ovarian steroid effect on endometrial leucocytes as they fail to express either oestrogen or progesterone receptors. The potential secondary effect produced by altered endometrial environment could be inferred from differences in some adhesion molecule distributions which have also been confirmed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available