Bone Marrow Cell Engraftment of the Uterus and Genetic Studies of Reproductive Functioning

Transplantation with hematopoietic cells has been used for a wide variety of blood disorders, but also for diseases like solid organ cancers. Interestingly, women who have had bone marrow transplants have been found to have donor tissue in their endometrium, which raises the possibility of cellular therapies using bone marrow derived cells for gynecologic indications. Donor engraftment does not appear to occur when transplantations were performed with stem cells collected from peripheral blood of the donor. Therefore, the subtype of cells from the bone marrow responsible for engraftment is not yet known, nor is the ideal transplantation regimen known.

The immediate aim of this tissue procurement protocol is to obtain endometrial (uterine) stem cells from many human volunteers in order to examine the biological properties of those cells. We will collect tissue from 3 primary groups of patients: normal controls, patients with rare diseases or reproductive disorders, and patients who have undergone hematopoietic stem cell transplant. Each volunteer will undergo an endometrial biopsy during an office visit. The endometrial tissue will then be studied for a better understanding of their biological properties, growth and differentiation. One specific area of interest is to study how hematopoietic transplantation impacts endometrial cell function. These endometrial cells will be analyzed in-depth in the laboratory to determine if they came from the donor or recipient, and if so, which specific populations of cells. Hematologic pre-transplant conditioning information will be correlated with these research studies to identify factors that may assist with the understanding of adult endometrial stem cell biology.

• INCLUSION CRITERIA:

Subject is able to give consent/assent to participate in the protocol.

Listed below are acceptable medical conditions for inclusion in this protocol:

• Age greater than or equal to 18 years old
• Female gender
• Presence of a uterus
• Fall into one of the following categories:
• Healthy volunteers
• Hematologic patients:
• Whole bone marrow transplant recipients
• Peripheral blood stem cell transplant recipients
• Mesenchymal stem cell transplant recipients
• Bone marrow or stem cell donors
• Fully ablative transplant recipients
• Nonmyeloablative transplant recipients
• Cord blood transplant recipients

Rare, interesting, or unique reproductive phenotypes that may provide insight to endometrial function in health and disease:

• Asherman s syndrome
• Endometriosis
• Abnormal uterine bleeding
• Recurrent pregnancy loss
• Infertility
• Implantation failure
• Reproductive disorders

Exclusion criteria

• Unable to comprehend the investigational nature of the protocol participation.
• Positive pregnancy test.
• Anticoagulation or known coagulopathy.
• Active gonorrhea or Chlamydia infections or pelvic inflammatory disease within the last 3 months.
• Previous hysterectomy or endometrial ablation procedure.
• Thrombocytopenia (<50,000).
• Uterine or cervical cancer.
• Cervical stenosis.