Pre-implantation endometrial leukocytes in women with recurrent miscarriage

Immunohistochemistry was used to investigate the leukocyte populations in the endometrium of women suffering recurrent miscarriage, Mid-luteal phase endometrial biopsies were taken from 22 patients with idiopathic recurrent miscarriage and from nine women with normal obstetric histories, The samples were dated histologically and stained with a panel of monoclonal antibodies to identify leukocytes, The outcome of any pregnancy in subsequent cycles following the biopsy was determined. Similar numbers of cluster designation (CD)3(+) and CD8(+) cells were seen in both groups, However, CD4(+), CD14(+), CD16(+), CD56(+) and MHC class II+ cells were significantly higher in the recurrent miscarriage group than in the controls. Two patients had B cells (CD22(+)) in their endometrium, No CD57(+) cells were seen in the controls; however eight of the patients had a few CD57(+) cells present, Only two patients, both from the recurrent miscarriage group, had CD69(+) leukocytes in their endometrium, Patients who had miscarriages following endometrial biopsy had significantly more CD4(+), CD8(+), CD14(+), CD16(+), and CD56(+) leukocytes in their endometrium than either those who had live births or women with proven fertility. A different population of leukocytes was found in the pre-implantation endometrium from recurrent miscarriage patients as compared to those from fertile controls, These differences were accentuated in women who had a miscarriage subsequent to the biopsy compared with those who subsequently had a Live birth.