Endometrial Stem/Progenitor Cell Markers in Polycystic Ovary Syndrome (PCOS) versus Non-PCOS Infertile Women: A Systematic Review of Molecular and Cellular Signatures

Abstract

The human endometrium is a highly regenerative tissue whose cyclical renewal is driven
by endometrial stem/progenitor cells, critical for successful implantation and fertility.
Polycystic Ovary Syndrome (PCOS), a prevalent endocrine disorder, disrupts endometrial
structure and function, potentially through altered stem/progenitor cell activity. This
systematic review aimed to compare the expression of key endometrial stem/progenitor
markers—CD146, SUSD2, Lgr5, SSEA-1, and N-cadherin—between infertile women with
and without PCOS. A comprehensive search of PubMed, Cochrane, and ScienceDirect
from 2015 to 2025 identified 20 eligible studies meeting strict inclusion criteria. Findings
consistently revealed dysregulation of stromal and epithelial progenitor markers in PCOS,
including reduced CD146/SUSD2 and altered Lgr5, SSEA-1, and N-cadherin expression,
associated with impaired stromal remodeling, epithelial renewal, and implantation
potential. These molecular alterations likely contribute to infertility and endometrial
dysfunction in PCOS. Future research should integrate functional assays and longitudinal
studies to clarify causal mechanisms and therapeutic targets