A subset of idiopathic RPLs is associated with reduced TEAD4 expression in CTB progenitors. (A) Micrographs show defective villi formation in a first-trimester (7 wk) placenta from a patient suffering from idiopathic RPL. A 7 wk placenta from elective pregnancy termination was used as a control. (B) Immunofluorescence images show defective trophoblast bilayer formation and strong reduction of TEAD4 expression in CTBs in idiopathic RPL placenta, shown in A. (C) Patient-specific human TSCs were established from CTBs, which were isolated from placentae, associated with idiopathic RPL. Micrographs show efficient establishment of TSC colonies from an idiopathic RPL, which was not associated with defective placental villi formation (RPL 10, Left). In contrast, TSC establishment was inefficient from an idiopathic RPL (RPL 7), which was characterized by defective placental villi formation. We could obtain small TSC colonies only in the presence of feeder mesenchymal stromal cells isolated from first-trimester human placenta.