Menstrual flow as a non-invasive source of endometrial organoids

Assessment of the endometrium often necessitates a biopsy, which currently involves an invasive, transcervical procedure. Here, we present an alternative technique based on deriving organoids from menstrual flow. We demonstrate that organoids can be derived from gland fragments recovered from menstrual flow. To confirm they faithfully reflect the in vivo state we compared organoids derived from paired scratch biopsies and ensuing menstrual flow from patients undergoing in vitro fertilisation (IVF). We demonstrate that the two sets of organoids share the same transcriptome signature, derivation efficiency and proliferation rate. Furthermore, they respond similarly to sex steroids and early-pregnancy hormones, with changes in morphology, receptor expression, and production of 'uterine milk' proteins that mimic those during the late-secretory phase and early pregnancy. This technique has wide-ranging impact for non-invasive investigation and personalised approaches to treatment of common gynaecological conditions, such as endometriosis, and reproductive disorders, including failed implantation after IVF and recurrent miscarriage. Tereza Cindrova-Davies et al. present a method for deriving endometrial organoids using menstrual flow collected from women. The approach shows promise as a personalised and non-invasive way to investigate gynaecological conditions such as endometriosis and failed implantation following IVF.

Automated summary

A novel technique using organoids derived from menstrual flow was presented as a non-invasive and personalized approach for investigating gynecological conditions like endometriosis and failed implantation after IVF. By comparing the organoids derived from menstrual flow with traditional biopsy samples, researchers found similar transcriptome signature, efficiency, and response to hormones, indicating a promising alternative method for diagnosis and treatment of common gynecological conditions.