Endometrial stem cells and human reproductive failure

Human reproductive failure is a frequent and multifactorial event. Emerging evidence involved endometrial dysfunction in implantation failure and recurrent pregnancy loss, highlighting the central role of endometrium in reproductive success. In this context it was demonstrated that human endometrial stromal cells are essential for endometrial physiology and pathology. Defects on stem cell compartment might be responsible for modifications of the “implantation window” and alterations of embryo/endometrium crosstalk causing impaired endometrial receptivity. It was indeed experimentally shown that endometrial stromal cells work as biosensors to recognize abnormal embryos. Some common endometrial dysfunctions associated to human reproductive failure, such as endometriosis, Asherman Syndrome, endometrial atrophy and adenomyosis present defects in the endometrial stem cell compartment. Although evidence confirms the role of endometrial mesenchymal stem cells in endometrial functions, several issues remain unsolved. A detailed understanding of biology of endometrial stem compartment could improve diagnosis and treatment strategies for reproductive failure. In this mini review the role of endometrial stem cells in the human reproductive failure are summarized and critically evaluated.