Endometrial gene expression in the window of implantation is altered in obese women especially in association with polycystic ovary syndrome

Bellver, José; Martínez-Conejero, José Antonio; Labarta, Elena; Alamá, Pilar; Melo, Marco; Remohı́, José; Pellicer, António; Horcajadas, José A.

doi:10.1016/j.fertnstert.2011.03.021

Cited by 159 publications

(95 citation statements)

References 49 publications

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“…In women with PCOS, there is a decreased endometrial secretory phase expression of selectins, integrin ␣ v ␤ 3 , and HOXA10 reducing the implantation potential of an embryo (306). A compounding factor for many women with PCOS is obesity which has a synergistic effect to reduce the chance of conception (29), leading to a greater perturbation in endometrial gene expression (29), as demonstrated by the association of an increase in BMI being associated with a reduced chance of conception using the oocyte donor model (81) [for a review, see Schulte et al (302)]. However, lifestyle interventions with diet and exercise will lead to alterations in endometrial gene expression (348), although it is not clear whether the improved conception rates noted due to lifestyle interventions are due to an endometrial effect, an oocyte effect, or a combination of both.…”

Section: Endometrial and Myometrial (Endometriosis Leiomyomas Hydromentioning

confidence: 99%

Physiological Aspects of Female Fertility: Role of the Environment, Modern Lifestyle, and Genetics

Hart

2016

Physiological Reviews

170

119

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Across the Western World there is an increasing trend to postpone childbearing. Consequently, the negative influence of age on oocyte quality may lead to a difficulty in conceiving for many couples. Furthermore, lifestyle factors may exacerbate a couple's difficulty in conceiving due mainly to the metabolic influence of obesity; however, the negative impacts of low peripheral body fat, excessive exercise, the increasing prevalence of sexually transmitted diseases, and smoking all have significant negative effects on fertility. Other factors that impede conception are the perceived increasing prevalence of the polycystic ovary syndrome, which is further exacerbated by obesity, and the presence of uterine fibroids and endometriosis (a progressive pelvic inflammatory disorder) which are more prevalent in older women. A tendency for an earlier sexual debut and to have more sexual partners has led to an increase in sexually transmitted diseases. In addition, there are several genetic influences that may limit the number of oocytes within the ovary; consequently, by postponing attempts at childbearing, a limitation of oocyte number may become evident, whereas in previous generations with earlier conception this potentially reduced reproductive life span did not manifest in infertility. Environmental influences on reproduction are under increasing scrutiny. Although firm evidence is lacking however, dioxin exposure may be linked to endometriosis, phthalate exposure may influence ovarian reserve, and bisphenol A may interfere with oocyte development and maturation. However, chemotherapy or radiotherapy is recognized to lead to ovarian damage and predispose the woman to ovarian failure.

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Section: Endometrial and Myometrial (Endometriosis Leiomyomas Hydromentioning

confidence: 99%

Physiological Aspects of Female Fertility: Role of the Environment, Modern Lifestyle, and Genetics

Hart

2016

Physiological Reviews

170

119

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“…Even when ovulation is pharmacologically restored, anovulatory patients have decreased cumulative pregnancy rates when compared with other subfertile populations 32 and exhibit a higher rate of implantation failure and spontaneous miscarriage. 30 Additionally, it is well established that the endometrium in patients with PCOS is dysfunctional, as women with PCOS are anovulatory or oligo-ovulatory and have suboptimal regulation by estrogen and suboptimal or absent progesterone, which puts them at increased risk for the development of endometrial hyperplasia and cancer. 14,[33][34][35] Gene expression studies to study this ''progesterone resistance'' in patients with PCOS show reduced expression of multiple endometrial receptivity-associated genes which may contribute to the observed subfertility.…”

Section: Introductionmentioning

confidence: 99%

Obesity and PCOS: The Effect of Metabolic Derangements on Endometrial Receptivity at the Time of Implantation

2015

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Successful embryonic implantation is the result of a receptive endometrium, a functional embryo at the blastocyst stage and a synchronized dialog between maternal and embryonic tissues. Successful implantation requires the endometrium to undergo steroid-dependent change during each menstrual cycle, exhibiting a short period of embryonic receptivity known as the window of implantation. The term ''endometrial receptivity'' was introduced to define the state of the endometrium during the window of implantation. It refers to the ability of the endometrium to undergo changes that will allow the blastocyst to attach, penetrate, and induce localized changes in the endometrial stroma. These changes are metabolically demanding, and glucose metabolism has been proven to be important for the preparation of the endometrium for embryo implantation. Obesity and polycystic ovary syndrome (PCOS) represent 2 common metabolic disorders that are associated with subfertility. The aim of this review is to summarize the effect of obesity and PCOS on endometrial receptivity at the time of implantation. Focus will be on metabolic alterations that regulate decidualization, including glucose metabolism, hyperinsulinemia, and hyperandrogenism.

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“…In this way, a series of abnormal situations including the selection of oocyte, ovulation, and the quality of oocyte occur (16)(17)(18). As is known, insulin resistance develops in overweight women.…”

Section: The Effect Of Obesity On Target Organs In the Reproductive Smentioning

confidence: 99%

“…Reproductive goals in obesity include hypothalamus, ovary, follicle, oocyte, embryo, and uterine endometrium (11)(12)(13)(14)(15)(16)(17)(18). The negative effect of obesity on fertility can occur at different stages, including the selection of follicle, development and quality of oocyte, fertilization of oocyte, and development and implantation of embryo.…”

Section: The Effect Of Obesity On Target Organs In the Reproductive Smentioning

confidence: 99%

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Effect of Obesity on Fertility

Karaca¹,

Batmaz²,

Aydin³

2015

Bezmialem Science

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Prior studies have shown that obesity causes many gynecologic and obstetric disorders, including anovulation, irregular periods, subfertility, abortion, and adverse pregnancy outcomes. Obesity-related infertility or reduced fertility problems were influenced by any step from follicular recruitment to implantation. Adverse effects in reproductive health were not subjected out of entire obese women. Physical activity and nutrition were shown to be the probable determining factors. Assisted reproductive techniques provide obese women with an opportunity to investigate the relationship with pregestational status and reproductive outcomes as well. Although there is a lack of epidemiological data, an association between obesity and abortion is already known in obese women who had spontaneous pregnancy. This study aimed to investigate the effects of obesity among various stages of the reproductive process in recent studies, to summarize multidisciplinary strategies, and to facilitate reproductive outcomes in obese women.

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Endometrial gene expression in the window of implantation is altered in obese women especially in association with polycystic ovary syndrome

Cited by 159 publications

References 49 publications

Physiological Aspects of Female Fertility: Role of the Environment, Modern Lifestyle, and Genetics

Physiological Aspects of Female Fertility: Role of the Environment, Modern Lifestyle, and Genetics

Obesity and PCOS: The Effect of Metabolic Derangements on Endometrial Receptivity at the Time of Implantation

Effect of Obesity on Fertility

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