Endometrial BCL6 Expression and Reproductive Outcomes in Infertile Women: A Systematic Review

Area of Science:

• Reproductive Medicine
• Endocrinology
• Molecular Biology

Background:

• Endometrial B-cell lymphoma 6 (BCL6) overexpression is linked to progesterone resistance, occult endometriosis, and endometrial dysfunction in infertile women.
• Its potential as a marker for reproductive outcomes and a guide for pre-embryo transfer management is of growing interest.
• The prognostic and clinical significance of BCL6 in various infertility settings remains unclear.

Purpose of the Study:

• To systematically review the literature on endometrial BCL6 expression and its association with reproductive outcomes in infertile women.
• To determine if high or abnormal BCL6 expression correlates with poorer reproductive outcomes.
• To assess if pre-embryo transfer treatments improve outcomes in BCL6-positive women.

Main Methods:

• Systematic review of 13 studies evaluating endometrial BCL6 expression on biopsy in infertile women.
• Inclusion criteria required reporting of reproductive outcomes or comparative data.
• Narrative synthesis of findings due to substantial heterogeneity in study designs and populations.

Main Results:

• Elevated endometrial BCL6 expression may be associated with poorer reproductive outcomes, especially in unexplained infertility with IVF.
• This association was less apparent in euploid embryo transfer cohorts.
• Treatment studies suggested potential benefits of medical suppression or surgical management in some BCL6-positive women, but results were variable.

Conclusions:

• Endometrial BCL6 is biologically and clinically relevant as a marker of endometrial dysfunction in select infertility cases.
• Current evidence is insufficient for routine standalone clinical use or definitive treatment recommendations.
• Larger prospective studies with standardized protocols and validation are needed to clarify BCL6's role in reproductive medicine.