Endometrial receptivity in the eutopic endometrium of women with endometriosis: it is affected, and let me show you why

Bruce A. Lessey*, J. Julie Kim

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

54 Scopus citations

Abstract

The endometrium maintains complex controls on proliferation and apoptosis as part of repetitive menstrual cycles that prepare the endometrium for the window of implantation and pregnancy. The reliance on inflammatory mechanisms for both implantation and menstruation creates the opportunity in the setting of endometriosis for establishment of chronic inflammation that is disruptive to endometrial receptivity, causing both infertility and abnormal bleeding. Clinically, there can be little doubt that the endometrium of women with endometriosis is less receptive to embryo implantation, and strong evidence exists to suggest that endometrial changes are associated with decreased cycle fecundity as a result of this disease. Here we provide unifying concepts regarding those changes and how they are coordinated to promote progesterone resistance and estrogen dominance through aberrant cell signaling pathways and reduced expression of key homeostatic proteins in eutopic endometrium of women with endometriosis.

Original languageEnglish (US)
Pages (from-to)19-27
Number of pages9
JournalFertility and Sterility
Volume108
Issue number1
DOIs
StatePublished - Jul 2017

Keywords

  • Endometriosis
  • endometrial receptivity
  • endometrium
  • implantation
  • progesterone resistance

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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