Effect of endometrial CD138 positive on pregnancy outcome in vitro fertilization-embryo transfer in
patients with repeated implantation failure
WANG Peiyu1, YANG Haiyan1, JIN Congcong1, LIN Jia1, JIN Wumin1, LI Jianmin2, HUANG Xuefeng1.
1.Reproductive Medicine Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China; 2.Department of Pathology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China
WANG Peiyu,YANG Haiyan,JIN Congcong, et al. Effect of endometrial CD138 positive on pregnancy outcome in vitro fertilization-embryo transfer in
patients with repeated implantation failure[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2024, 54(5): 355-362..
Abstract：Objective: To study the effect of endometrial CD138 positive test on the clinical pregnancy outcome of in vitro fertilization-embryo transfer (IVF-ET) in patients with unexplained repeated implantation failure (RIF). Methods: A total of 332 patients (352 cycles) with unexplained RIF were selected for endometrial biopsy, immunohistochemical detection of CD138 positive cells in the First Affiliated Hospital of Wenzhou Medical University from July 2019 to May 2023. According to the detection results, they were divided as CD138-positive group and negative group. And according to the number of CD138-positive cell under 20 high-power field (20 HPFs), they were further divided into 1-5 /20 HPFs group, 6-20/20 HPFs group and >20/20 HPFs group.Some of the CD138 positive patients were treated with antibiotics, and the pregnancy outcome was followed up.Results: In 352 cycles, 181 cycles were positive for CD138, with the positive rate of 51.42%. Among them, there were 72 cycles in 1-5/20 HPFs group (39.78%), 63 cycles in 6-20/20 HPFs group (34.81%), and 46 cycles in >20/20 HPFs group (25.41%). Multivariate Logistic regression analysis showed that CD138 positive was one of the factors reducing clinical pregnancy rate (OR=-0.474, 95%CI=0.395-0.98, P=0.041). The clinical pregnancy rate and embryo implantation rate in CD138 positive group were significantly lower than those in negative group (P<0.05). When the number of CD138 positive cells was more than 20 for per 20HPFs, the clinical pregnancy rate and embryo implantation rate were significantly lower than those in the negative group (P<0.05). When the number of C138 was less than 5 for per 20 HPFs, there was no significant difference in pregnancy outcomes between antibiotic treatment and untreated groups. Patients with persistent CD138 cell positive after antibiotic treatment had significantly lower rate of clinical pregnancy embryo implantation and live birth than patients with initial negative of CD138 cell (P<0.05). Patients who turned negative of CD138 cell after treatment had similar clinical pregnancy rate, embryo implantation rate and live birth rate compared with those who had the initial negative of CD138 cells. Conclusion: The number of CD138-positive cells in endometrium more than 20 for per 20 HPFs may reduce the embryo implantation rate and clinical pregnancy rate. The clinical pregnancy outcomes can be improved if CD138 turns negative after antibiotic treatment, but persistently positive CD138 can affect the pregnancy outcome. A small amount of CD138 positive (<5/20 HPFs) at the initial test had no significant effect on the pregnancy outcome.
