{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T18:03:43Z","timestamp":1788631423925,"version":"build-2803163510"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017607","name":"Shenzhen Fundamental Research Program","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100017607","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study was conducted to determine the influence of the number of CD138<jats:sup>+<\/jats:sup> cells in the proliferative endometrium on pregnancy outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study was conducted from January to August 2018. A total of 664 infertile women who were not diagnosed with chronic endometritis (CE) and who had not received the respective antibiotic treatment were studied. Immunostaining was performed for the plasmacyte marker CD138. The number of CD138+ cells was compared in the proliferative and mid-luteal phases of the same patients without antibiotic therapy. Infertile patients were separated into three groups based on the number of positive lesions [the number of high power fields (HPFs) containing no less than five CD138<jats:sup>+<\/jats:sup> cells]: 0 (n = 474), 1-2 (n = 125), and <jats:bold>\u2265<\/jats:bold>3 positive lesions (n = 104). The pregnancy outcomes of the infertile women undergoing <jats:italic>in vitro<\/jats:italic> fertilization-embryo transfer (IVF-ET) among the three groups were then compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a much higher level of CD138+ cells during proliferation than during the mid-luteal phase (P &amp;lt;0.0001). Pregnancy outcomes did not differ between the groups with 0 and 1-2 positive lesions. However, the \u22653 positive lesions group (<jats:italic>P<\/jats:italic> =0.006, <jats:italic>P<\/jats:italic> =0.029) had significantly lower ongoing pregnancy and live birth rates compared with the no positive lesion group. Although the 0 and \u22653 positive lesions groups showed a trend toward higher rates of clinical pregnancy (<jats:italic>P<\/jats:italic> =0.132), these differences failed to reach statistical significance. After age, body mass index (BMI), and clinical features were adjusted for, the <jats:italic>\u2265<\/jats:italic>3 positive lesions group showed significantly lower live birth rates (aOR, 1.84; 95%CI, 1.08-3.15; <jats:italic>P<\/jats:italic> =0.026), clinical pregnancy (adjusted odds ratio (aOR), 1.78; 95% CI, 1.06-2.95; <jats:italic>P<\/jats:italic> =0.028), and ongoing pregnancy (aOR, 1.85; 95% CI, 1.09-3.15; <jats:italic>P<\/jats:italic> =0.024). The analysis demonstrated that the smallest number of stromal CD138<jats:sup>+<\/jats:sup> cells suggestive of CE patients requiring treatment was defined as <jats:italic>\u2265<\/jats:italic> 3 positive lesions during the proliferation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Different diagnostic criteria for CE should be created for the proliferative and mid-luteal phases. The analysis demonstrated that the smallest number of stromal CD138<jats:sup>+<\/jats:sup> cells suggestive of CE patients was defined as <jats:italic>\u2265<\/jats:italic> 3 positive lesions during the proliferative phase.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2024.1437781","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T05:20:58Z","timestamp":1737523258000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["The effect of the number of endometrial CD138+ cells on the pregnancy outcomes of infertile patients in the proliferative phase"],"prefix":"10.3389","volume":"15","author":[{"given":"Yuye","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuyi","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjuan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yawen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaobing","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juanhua","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingjuan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanying","family":"You","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruochun","family":"Lian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyu","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanru","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fenghua","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianghui","family":"Diao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1016\/j.fertnstert.2013.11.004","article-title":"The nature of aneuploidy with increasing age of the female partner: a review of 15,169 consecutive trophectoderm biopsies evaluated with comprehensive chromosomal screening","volume":"101","author":"Franasiak","year":"2014","journal-title":"Fertil Steril"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmy044","article-title":"Conventional and modern markers of endometrial receptivity: a systematic review and meta-analysis","volume":"25","author":"Craciunas","year":"2019","journal-title":"Hum Reprod Update"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2250","DOI":"10.3390\/diagnostics12092250","article-title":"Chronic endometritis in infertile women: impact of untreated disease, plasma cell count and antibiotic therapy on IVF outcome-A systematic review and meta-analysis","volume":"12","author":"Vitagliano","year":"2022","journal-title":"Diagnost (Basel)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e13369","DOI":"10.1111\/aji.13369","article-title":"Diagnosis of chronic endometritis: How many CD138(+) cells\/HPF in endometrial stroma affect pregnancy outcome of infertile women","volume":"85","author":"Li","year":"2021","journal-title":"Am J Reprod Immunol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.09.039","article-title":"The impact of chronic endometritis on reproductive outcome","volume":"96","author":"Kasius","year":"2011","journal-title":"Fertil Steril"},{"key":"B6","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s12958-017-0233-x","article-title":"Chronic endometritis modifies decidualization in human endometrial stromal cells","volume":"15","author":"Wu","year":"2017","journal-title":"Reprod Biol Endocrinol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2007.03.074","article-title":"Chronic endometritis: correlation among hysteroscopic, histologic, and bacteriologic findings in a prospective trial with 2190 consecutive office hysteroscopies","volume":"89","author":"Cicinelli","year":"2008","journal-title":"Fertil Steril"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1159\/000223819","article-title":"Poor reliability of vaginal and endocervical cultures for evaluating microbiology of endometrial cavity in women with chronic endometritis","volume":"68","author":"Cicinelli","year":"2009","journal-title":"Gynecol Obstet Invest"},{"key":"B9","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1038\/s41467-017-00901-0","article-title":"The microbiota continuum along the female reproductive tract and its relation to uterine-related diseases","volume":"8","author":"Chen","year":"2017","journal-title":"Nat Commun"},{"key":"B10","article-title":"Chronic endometritis: morphologic and clinical observations","volume":"58","author":"Greenwood","year":"1981","journal-title":"Obstet Gynecol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2005.07.394","article-title":"Detection of chronic endometritis at fluid hysteroscopy","volume":"12","author":"Cicinelli","year":"2005","journal-title":"J Minim Invasive Gynecol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2010.98","article-title":"Aberrant expression of selectin E, CXCL1, and CXCL13 in chronic endometritis","volume":"23","author":"Kitaya","year":"2010","journal-title":"Mod Pathol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/des323","article-title":"Local mononuclear cell infiltrates in infertile patients with endometrial macropolyps versus micropolyps","volume":"27","author":"Kitaya","year":"2012","journal-title":"Hum Reprod"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2021.01.034","article-title":"Chronic endometritis impairs embryo implantation in patients with repeated implantation failure: A retrospective study","volume":"61","author":"Li","year":"2022","journal-title":"Taiwan J Obstet Gynecol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2019.09.001","article-title":"Evaluation of peripheral and uterine immune status of chronic endometritis in patients with recurrent reproductive failure","volume":"113","author":"Li","year":"2020","journal-title":"Fertil Steril"},{"key":"B16","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1093\/molehr\/3.4.299","article-title":"Expression of syndecan-1 in female reproductive tract tissues and cultured keratinocytes","volume":"3","author":"Inki","year":"1997","journal-title":"Mol Hum Reprod"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2012.824","article-title":"Inter-observer and intra-observer variability in immunohistochemical detection of endometrial stromal plasmacytes in chronic endometritis","volume":"5","author":"Kitaya","year":"2013","journal-title":"Exp Ther Med"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2021.04.036","article-title":"Redefining chronic endometritis: the importance of endometrial stromal changes","volume":"116","author":"Mcqueen","year":"2021","journal-title":"Fertil Steril"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2022.07.011","article-title":"The menstrual cycle phase impacts the detection of plasma cells and the diagnosis of chronic endometritis in endometrial biopsy specimens","volume":"118","author":"Ryan","year":"2022","journal-title":"Fertil Steril"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2006.06.042","article-title":"Immunological localization of syndecan-1 in human endometrium throughout the menstrual cycle","volume":"87","author":"Lai","year":"2007","journal-title":"Fertil Steril"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e13065","DOI":"10.1111\/aji.13065","article-title":"Endometrial microbes and microbiome: Recent insights on the inflammatory and immune \u201cplayers\u201d  of the human endometrium","volume":"80","author":"D\u2019ippolito","year":"2018","journal-title":"Am J Reprod Immunol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"101586","DOI":"10.1016\/j.tice.2021.101586","article-title":"Clinical consequences of defective decidualization","volume":"72","author":"Ticconi","year":"2021","journal-title":"Tissue Cell"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/0028-2243(91)90058-S","article-title":"Variation during the menstrual cycle of immune cell populations","volume":"39","author":"Starkey","year":"1991","journal-title":"Eur J Obsfefrics Gynecol Reprod Biol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1801350","article-title":"Effector and activated T cells induce preterm labor and birth that is prevented by treatment with progesterone","volume":"202","author":"Arenas-Hernandez","year":"2019","journal-title":"J Immunol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1172\/JCI0214873","article-title":"Estrogen alters thresholds for B cell apoptosis and activation","volume":"109","author":"Grimaldi","year":"2002","journal-title":"J Clin Invest"},{"key":"B26","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.molimm.2012.06.013","article-title":"Murine BAFF expression is up-regulated by estrogen and interferons: implications for sex bias in the development of autoimmunity","volume":"53","author":"Panchanathan","year":"2013","journal-title":"Mol Immunol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1530\/jrf.0.0770091","article-title":"Effects of oestradiol-17 beta and progesterone on the number of plasma cells in uteri of ovariectomized mice","volume":"77","author":"Parr","year":"1986","journal-title":"J Reprod Fertil"},{"key":"B28","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1016\/j.ajog.2016.09.075","article-title":"Evidence that the endometrial microbiota has an effect on implantation success or failure","volume":"215","author":"Moreno","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"485","DOI":"10.3390\/ijms23010485","article-title":"The endometrial microbiome and its impact on human conception","volume":"23","author":"Toson","year":"2022","journal-title":"Int J Mol Sci"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2024.1437781\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T05:21:02Z","timestamp":1737523262000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2024.1437781\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,22]]},"references-count":29,"alternative-id":["10.3389\/fendo.2024.1437781"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2024.1437781","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,22]]},"article-number":"1437781"}}