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Fertile ground: human endometrial programming and lessons in health and disease
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Journal Article
Fertile ground: human endometrial programming and lessons in health and disease
2016
Overview
Key Points
The human endometrium is a unique, dynamic tissue that is cyclically shed, repaired, regenerated and remodelled, in preparation for embryo implantation
Decidualization in women occurs spontaneously (regardless of the presence of an embryo) during the mid-to-late luteal phase, necessitating endometrial shedding and subsequent regeneration in the absence of conception
Endometrial remodelling occurs primarily under the orchestration of oestrogen and progesterone, but is influenced by many factors, including epigenetic signals and stem/progenitor cells
Abnormalities in endometrial remodelling lead to pathologies including infertility, endometriosis and pregnancy disorders
Understanding the processes that operate in the endometrium could provide information that is applicable to nonreproductive pathologies such as cancer and wound healing
The human endometrium repeatedly undergoes specific cyclic changes to prepare for embryo implantation. Understanding the mechanisms involved in endometrial cycling is important for the treatment of reproductive pathologies, and can also provide insight into conditions such as wound healing and even cancer.
The human endometrium is a highly dynamic tissue that is cyclically shed, repaired, regenerated and remodelled, primarily under the orchestration of oestrogen and progesterone, in preparation for embryo implantation. Humans are among the very few species that menstruate and that, consequently, are equipped with unique cellular and molecular mechanisms controlling these cyclic processes. Many reproductive pathologies are specific to menstruating species, and studies in animal models rarely translate to humans. Abnormal remodelling and regeneration of the human endometrium leads to a range of reproductive complications. Furthermore, the processes regulating endometrial remodelling and implantation, including those controlling hormonal impact, breakdown and repair, stem/progenitor cell activation, inflammation and cell invasion have broad applications to other fields. This Review presents current knowledge regarding the normal and abnormal function of the human endometrium. The development of biomarkers for prediction of uterine diseases and pregnancy disorders and future avenues of investigation to improve fertility and enhance endometrial function are also discussed.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Abortion, Spontaneous - metabolism
/ Abortion, Spontaneous - physiopathology
/ Biology
/ Embryo Implantation - physiology
/ Embryos
/ Endometriosis - physiopathology
/ Female
/ Gynatresia - physiopathology
/ Humans
/ Infertility, Female - metabolism
/ Infertility, Female - physiopathology
/ Ovaries
/ Polycystic Ovary Syndrome - metabolism
/ Polycystic Ovary Syndrome - physiopathology
/ Reproductive Techniques, Assisted
/ Steroids
