Endometriosis-Associated Infertility and Defective Decidualization

doi:10.12280/gjszjk.20250111

Abstract

Abstract:

Endometriosis (EMs) is one of the major causes of infertility in women of reproductive age. Defective decidualization is a key factor contributing to EMs-related infertility. Aberrant epigenetic regulation, progesterone resistance and dysregulated endometrial immune-inflammatory microenvironment are important pathological mechanisms underlying the decidualization defects in EMs, yet the specific mechanisms remain unclear. By reviewing relevant literatures, it has been found that epigenetic abnormalities in EMs mainly affect the expressions of decidualization-related genes through DNA methylation, RNA methylation, and histone modifications. Progesterone resistance in the endometrium leads to abnormal regulation of downstream gene expression and signaling pathways of progesterone receptors, hindering the decidualization process. Moreover, abnormal changes in endometrial immune cells, cytokines, and inflammatory pathways lead to dysregulation of the endometrial immune-inflammatory microenvironment, which impair the processes of decidualization and embryo implantation, which ultimately result in EMs-related infertility.

Key words: Endometriosis, Infertility, female, Epigenomics, Defective decidualization, Progesterone resistance

DENG Shi-jing, ZHANG Zhe, LI Ze, ZHANG Wei. Endometriosis-Associated Infertility and Defective Decidualization[J]. Journal of International Reproductive Health/Family Planning, 2025, 44(4): 325-331.

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