Aging endometrium in young women: molecular classification of endometrial aging-based markers in women younger than 35 years with recurrent implantation failure

Background To explore the differences between a population with premature endometrial aging and a population with normal endometrial status in young women with recurrent implantation failure (<35 years). Methods Systematic analysis of the endometrium transcriptome of 274 RIF women. The NMF algorithm was used for classification based on endometrial-specific aging markers in CellAge, and the endometrial receptivity, gene expression patterns, and clinical data were compared between the classifications. Results Two hundred forty-five young RIF women could be divided into two clusters, in which the aging gene expression pattern of cluster 2 was closer to the reference cluster. Cluster 1 was characterized by high immune activity, while cluster 2 was characterized by high metabolic activity. Combined with clinical data, cluster 2 was worse than cluster 1 in window of implantation deviation rate and endometrial receptivity. Conclusion Premature aging of the endometrium exists in young women with RIF, and premature aging of the endometrium was associated with poor reproductive outcomes.

Automated summary

This study revealed the presence of premature endometrial aging in young women with recurrent implantation failure, which is associated with poor reproductive outcomes. Analysis of gene expression patterns categorized the women into two clusters, with cluster 2 showing worse endometrial receptivity.