Endometriosis at the Single-Cell Level: Molecular Insights and Implications for Assisted Reproduction Success

Area of Science:

• Reproductive Biology
• Cellular and Molecular Medicine
• Immunology

Background:

• Endometriosis is a chronic disorder causing infertility, characterized by ectopic endometrial tissue disrupting pelvic homeostasis.
• Single-cell 'omics' reveal cellular diversity and altered signaling in eutopic endometrium and lesions, impacting oocyte and embryo quality.
• This dysfunction contributes to inflammation, hormonal imbalance, and immune issues in endometriosis patients.

Purpose of the Study:

• To investigate the cellular and molecular mechanisms underlying infertility in endometriosis using single-cell analyses.
• To identify how cellular dysfunction in endometriosis affects assisted reproductive technology (ART) outcomes.
• To explore the potential of single-cell data for developing personalized therapeutic strategies.

Main Methods:

• Application of single-cell 'omic' technologies to analyze cellular diversity in endometriosis.
• Dissection of molecular signatures within individual cells from eutopic endometrium, lesions, oocytes, and granulosa cells.
• Integration of single-cell findings with clinical data on ART success rates.

Main Results:

• Single-cell analyses identified distinct cell populations with unique transcriptional profiles in endometriosis.
• Transcriptomic and epigenetic alterations in oocytes and endometrial cells affect mitochondrial function, steroid metabolism, and immune regulation.
• Evidence suggests endometriosis-associated infertility stems from coordinated ovarian and endometrial cellular defects, impacting implantation and ART success.

Conclusions:

• Single-cell studies provide mechanistic insights into endometriosis-associated reproductive failure, highlighting cellular-level dysfunctions.
• Candidate biomarkers identified can improve patient stratification and predict ART outcomes.
• Single-cell technologies are crucial for advancing precision reproductive medicine and personalized endometriosis management.