The endometrial factor in recurrent pregnancy loss

Cheong, Ying and Borges Manna, Luiza (2020) The endometrial factor in recurrent pregnancy loss. In, Carp, Howard (ed.) Recurrent Pregnancy Loss: Causes, Controversies and Treatment. Third Edition ed. CRC Press.

Record type: Book Section

Abstract

The endometrium is a highly adaptable and dynamic tissue that has the ability to differentiate into secretory decidual cells capable of establishing and sustaining pregnancy. For decades, the decidualised endometrium has been thought to play a passive role in implantation. This paradigm has now been challenged with findings that the decidua in fact acts as a biosensor of embryo-quality, selecting those that are most likely to progress to term and make maternal investment in pregnancy worthwhile. In this chapter, the mechanisms through which the endometrium differentiates into the highly selective decidua, and the molecular basis for the embryo-endometrial cross-talk will be reviewed. Disruptions in this mechanism that have been linked to recurrent pregnancy loss will also be discussed. In addition, the authors provide an overview on local immunological factors that might be accountable for recurrent miscarriage, and a discussion of clinical implications of such data.

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