Advancements in single-cell analyzis technologies, particularly single-cell RNA sequencing (scRNA-seq) and Fluorescence-Activated Cell Sorting (FACS), have enabled the analyzis of cellular diversity by providing resolutions that were not available previously. These methods enable the simultaneous analyzis of thousands of individual transcriptomes, facilitating the classification of cells into distinct subpopulations, based on transcriptomic differences, adding a new level of complexity to biomolecular and medical research. Fibroblasts, despite being one of the most abundant cell types in the human body and forming the structural backbone of tissues and organs, remained poorly characterized for a long time. This is largely due to the high morphological similarity between different types of fibroblasts and the lack of specific markers to identify distinct subpopulations. Once thought to be cells responsible solely for the synthesis of extracellular matrix (ECM) components, fibroblasts are now recognized as active participants in diverse physiological processes, including inflammation and antimicrobial responses. However, defining the molecular profile of fibroblast subpopulations remains a significant challenge. In this comprehensive review, which is based on over two thousand research articles, we focus on the identification and characterization of fibroblast subpopulations and their specific surface markers, with an emphasis on their potential as molecular targets for selective cell isolation. By analyzing surface markers, alongside intra- and extracellular protein profiles, we identified multiple fibroblast subtypes within the female reproductive system. These subtypes exhibit distinct molecular signatures and functional attributes, shaped by their anatomical localization and the surrounding physiological or pathological conditions. Our findings underscore the heterogeneity of fibroblasts and their diverse roles in various biological contexts. This improved understanding of fibroblast subpopulations paves the way for innovative diagnostic and therapeutic strategies, offering the potential for precision targeting of specific fibroblast subsets in clinical applications.

Background/Objectives: Chronic endometritis (CE) is a subclinical inflammation of the endometrium that affects female fertility. Although awareness of its impact on reproductive outcomes has increased significantly, clinical management—especially the diagnostic value of hysteroscopy and the effectiveness of perioperative antibiotic prophylaxis in improving fertility—remains unclear. Methods: This retrospective analysis involved 136 infertile women (30–44 years) who underwent diagnostic hysteroscopy between 2022 and 2023 at the Military Institute of Medicine in Warsaw. Women with intrauterine pathologies or other infertility factors were excluded. Hysteroscopic indicators of chronic endometritis (CE) included micropolyps and endometrial hyperemia. Endometrial biopsies were stained with CD138 and CE was diagnosed based on ≥5 plasma cells per 10 high-power fields. A single oral dose of azithromycin was administered post-procedure and pregnancy outcomes were assessed 12 months later. Results: CE was histologically confirmed in 29.2% of patients. The presence of micropolyps demonstrated a strong correlation with CE (p < 0.0001), although CE was also found in 21% of patients with normal hysteroscopic findings. While CE status did not significantly influence pregnancy rates, patients who received azithromycin exhibited a significantly higher conception rate (53% vs. 21%, p = 0.022). Additionally, secondary infertility was associated with higher reproductive success compared to primary infertility (54% vs. 24%, p = 0.022). Conclusions: Micropolyps are a specific hysteroscopic marker of CE. However, histologic inflammation markers may be present even in the absence of abnormal hysteroscopic findings. Furthermore, the routine use of antibiotic prophylaxis is associated with improved reproductive outcomes.

Endometriosis is a complex disorder associated with dysregulated immune, hormonal, and microenvironmental signaling. Extracellular vesicles (EVs) are important mediators of intercellular communication and may contribute to disease pathogenesis, biomarker discovery, and therapeutic targeting. Here, we systematically reviewed the literature on EVs in endometriosis, focusing on EV classification, isolation and characterization methods, and the functional relevance of EV-associated cargo. A total of 50 original studies were included and evaluated in the context of current International Society for Extracellular Vesicles (ISEV) recommendations. Our analysis revealed marked heterogeneity in EV nomenclature, biological sources, and methodological approaches. Although most studies used standard EV markers, the assessment of sample purity and inclusion of negative controls was inconsistent. Further studies using standardized workflows and well-characterized cohorts are needed to clarify their biological and clinical significance.

Background: Hysteroscopic endometrial fundal incision (HEFI) is a novel addition to the standard IVF procedure. This study aimed to evaluate whether different depths of incision during HEFI could affect reproductive outcomes in oocyte recipients. Methods: A prospective analysis was conducted on women who underwent HEFI 1–2 months prior to embryo transfer with donor oocytes. Patients were categorized into three groups based on the depth of incision: U2a (superficial level) U2aa (intermediate level), and U2aaa (deep level). Pregnancy and live birth rates were assessed. Results: A total of 212 women without intrauterine pathology were included. Positive pregnancy rates were 78% in U2a, 76.9% in U2aa, and 77.1% in U2aaa (p = 0.95). Live birth rates were 58.5%, 57.1%, and 56.4%, respectively (p = 0.97). Early and late miscarriage rates and biochemical pregnancies showed no significant differences between the groups. Conclusions: Based on the results obtained, we could speculate that the depth of infiltration during HEFI does not significantly influence reproductive outcomes in oocyte recipients without intrauterine pathology. However, these findings should be interpreted with caution, given the limitations of the study, including its non-randomized design and differences among groups, such as variations in the number of embryos transferred and intraoperative group allocation. Therefore, further randomized clinical trials should be performed to more comprehensively understand the impact of incision depth on reproductive outcomes.

Sprawozdanie z XXII Kongresu Europejskiego Towarzystwa Ginekologii Onkologicznej, który odbył się w dniach 23-25 października 2021 r. w Pradze.