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Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Osseous metaplasia in the endometrium is a rare pathological condition characterised by the presence of mature bone, potentially leading to menorrhagia and infertility. The probable pathogenesis of this condition is metaplastic alterations in the endometrial stromal cells, leading to the formation of bony spicules. The gold standard for diagnosis of the condition remains histopathological examination, aided by radiological findings. Methods: This was a case report of a single case with evidence-based discussions. Informed consent was obtained. Case report: We present a case of a 26-year-old female with a previous lower segment caesarean section (LSCS) five years ago and an abortion, followed by dilation and curettage three years ago, presented with heavy menstrual bleeding. Trans-vaginal ultrasound revealed bright, highly echogenic and linear echo-reflective shadows in the endometrial cavity. The complete removal of bony spicules from the endometrium was done by hysteroscopy under sonographic guidance. On histology, a diagnosis of osseous metaplasia of the endometrium was given. Conclusion: The accuracy of the diagnosis is pivotal; it signifies a reversible factor contributing to infertility. Therefore, an accurate identification not only aids in appropriate treatment but also offers substantial relief and hope for those experiencing fertility challenges due to this condition. [ABSTRACT FROM AUTHOR]

Importance: The creation of robust maternal-embryonic interactions and implantation models is important for comprehending the early stages of embryonic development and reproductive disorders. Traditional two-dimensional (2D) cell culture systems often fail to accurately mimic the highly complex in vivo conditions. The employment of three-dimensional (3D) organoids has emerged as a promising strategy to overcome these limitations in recent years. The advancements in the field of organoid technology have opened new avenues for studying the physiology and diseases affecting female reproductive tract. Observations: This review summarizes the current strategies and advancements in the field of 3D organoids to establish maternal-embryonic interaction and implantation models for use in research and personalized medicine in assisted reproductive technology. The concepts of endometrial organoids, menstrual blood flow organoids, placental trophoblast organoids, stem cell-derived blastoids, and in vitro-generated embryo models are discussed in detail. We show the incorportaion of organoid systems and microfluidic technology to enhance tissue performance and precise management of the cellular surroundings. Conclusions and Relevance: This review provides insights into the future direction of modeling maternal-embryonic interaction research and its combination with other powerful technologies to interfere with this dialogue either by promoting or hindering it for improving fertility or methods for contraception, respectively. The merging of organoid systems with microfluidics facilitates the creation of sophisticated and functional organoid models, enhancing insights into organ development, disease mechanisms, and personalized medical investigations. [ABSTRACT FROM AUTHOR]

Neospora caninum is an obligate intracellular parasite that causes abortion in ruminants. Different strains produce differences in the severity of disease outcomes. These differences may cause physiological or pathological changes in cells, modifying the intercellular interactions and intracellular transport pathways that could be evidenced by identifying the terminal sugars. This study aimed to characterize the oligosaccharide pattern in the bovine placenta and uterus after infection with tachyzoites of three different strains of N. caninum (Nc-1, Nc-6 Argentina and Nc Spain-7) during early gestation. Fourteen heifers were inoculated intravenously on day 70 of gestation with 2 × 108 N. caninum tachyzoites and samples of placentae and uteri were analysed by histology and lectin histochemistry. In the infected groups, severe placentitis was associated with changes in lectin binding in the vascular endothelium by Lens culinaris agglutinin (LCA), Pisum sativum agglutinin (PSA) and Ricinus communis I (RCA-I) lectins, in the epithelial cells of the endometrial glands by RCA-I, Dolichos biflorus agglutinin (DBA), succinylated wheat germ agglutinin, peanut agglutinin (PNA), concanavalin-A (CON-A), LCA, PSA and Phaseolus vulgaris erythroagglutinin (PHA-e), and in the trophoblast layer by PNA, CON-A, LCA, PSA, PHA-e, soybean agglutinin, RCA-I, DBA and Bandieraea simplicifolia agglutinin (BSA-I). The results suggest that N. caninum causes changes in the glycosylation pattern in the maternofetal interface tissues and might cause abortions in early gestation due to changes in the cellular structure of the placenta. [ABSTRACT FROM AUTHOR]

Drug therapy is one of the most important strategies for treating gynecological diseases. Local drug delivery is promising for achieving optimal regional drug exposure, considering the complex anatomy and dynamic environment of the upper genital tract. Here, we present microparticle-based microcarriers with a hierarchical structure for localized dienogest (DNG) delivery and endometriosis treatment. The microparticles were fabricated by microfluidics and consisted of photo-crosslinked bovine serum albumin hydrogel particles (D@P-B MPs) encapsulating DNG-loaded PLGA (poly lactic-co-glycolic acid) microspheres. Such design enables the microparticles to have sustained release capacity and cell adhesion ability. Based on this, the microparticles were applied for the treatment of peritoneal endometriosis through intraperitoneal injection. The performance of the microparticles in inhibiting the growth of ectopic lesions as well as their anti-inflammatory, anti-angiogenesis, and pelvic pain-relieving effects are well demonstrated in vivo. These findings indicate that the present hierarchical microparticles are good candidates for localized treatment of endometriosis and are promising for the management of gynecological diseases. We prepared photo-crosslinked bovine serum albumin hydrogel particles (D@P-B MPs) encapsulating DNG-loaded PLGA microspheres using microfluidic electrospray. Such hierarchical structure provided multiple functions of the particles as drug carriers. The hierarchical microparticles not only supported the sustained release of drugs but also provided adhesion to human ectopic endometrial stromal cells. The hierarchical microparticles represented a localized treatment method for endometriosis and is promising for the management of gynecological diseases. [Display omitted] [ABSTRACT FROM AUTHOR]

Intrauterine adhesions (IUA) are the most common cause of uterine infertility, and conventional treatments have not consistently achieved satisfactory pregnancy rates. Stem cell therapy shows promising potential for the clinical treatment of IUA. Although various advanced biomaterials have been designed for delivering stem cells to the uterine cavity, there remain significant challenges, particularly in devising therapeutic strategies for clinical application that minimize surgical incisions and conform to the intricate structure of uterine cavity. Herein, an injectable hydrogel loaded with human umbilical cord-derived mesenchymal stem cells (UCMSCs) was synthesized via the Diels-Alder click reaction for endometrial regeneration and fertility restoration, exhibiting suitable mechanical properties, good biocompatibility, and desirable degradation properties. Notably, this hydrogel permitted minimally invasive administration and integrated seamlessly with surrounding tissue. Our study revealed that the UCMSCs-laden injectable hydrogel enhanced cell proliferation, migration, angiogenesis, and exhibited anti-fibrotic effects in vitro. The implantation of this hydrogel significantly facilitated endometrium regeneration and restored fertility in a rat endometrial damage model. Mechanistically, in vivo results indicated that the UCMSCs-laden injectable hydrogel effectively promoted macrophage recruitment and facilitated M2 phenotype polarization. Collectively, this hydrogel demonstrated efficacy in regenerating damaged endometrium, leading to the restoration of fertility. Consequently, it holds promise as a potential therapeutic strategy for endometrial damage and fertility decline arising from intrauterine adhesions. Severe endometrial traumas frequently lead to intrauterine adhesions and subsequent infertility. Stem cell therapy shows promising potential for the clinical treatment of IUA; however, challenges remain, including low delivery efficiency and compromised stem cell activity during the delivery process. In this study, we fabricated an injectable hydrogel loaded with UCMSCs via the Diels-Alder click reaction, which exhibited unique bioorthogonality. The in situ-gelling hydrogels could be introduced through a minimally invasive procedure and adapt to the intricate anatomy of the uterus. The UCMSCs-laden injectable hydrogel promoted endometrial regeneration and fertility restoration in a rat endometrial damage model, efficaciously augmenting macrophage recruitment and promoting their polarization to the M2 phenotype. The administration of UCMSCs-laden injectable hydrogel presents a promising therapeutic strategy for patients with severe intrauterine adhesion. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Recently, there has been a growing interest in stem cells for human medicine. Limited feline endometrial mesenchymal stem cell (fEM-MSC) research in veterinary medicine necessitates reporting for future feline disease research and therapy. Objectives: This study aimed to isolate fEM-MSCs from feline endometrial tissues and evaluate their morphology, proliferative ability, differentiation ability, and immunophenotype. Methods: Feline endometrial tissues were obtained from the ovariohysterectomies of healthy cats and isolated using an enzymatic method. The morphology and proliferative ability of the isolated cells were assessed using a doubling time (DT) assay from passages 3 to 6 (P3 - P6). We measured pluripotency gene expressions of cells in P2 using quantitative real-time polymerase chain reaction (qRT-PCR). To investigate MSC characteristics, a trilineage differentiation assay was conducted in P4, and cells in P4 were immunophenotyped using flow cytometry. Results: fEM-MSCs showed a typical spindle-shaped morphology under a microscope, and the DT was maintained from P3 to P6. fEM-MSCs could differentiate into adipocytes, osteoblasts, and chondrocytes, and expressed three pluripotency markers (OCT4, SOX2, and NANOG) by qRT-PCR. Immunophenotypic analysis showed that the fEM-MSCs were CD14-, CD34-, CD45-, CD9+, and CD44+. Conclusions: In this study, the feline endometrium was a novel source of MSCs, and to the best of our knowledge, this is the first report on the isolation method and characteristics of fEM-MSCs. [ABSTRACT FROM AUTHOR]

An 11-year-old female Persian cat underwent ovariohysterectomy due to dilation of the uterine cavity with irregular thickening of the wall. Macroscopically, the middle and distal regions of the left uterine horn were swollen and the uterine wall was irregularly thickened due to the development of multiple coalescent, variably sized nodules. Microscopically, the nodules had originated in the endometrium and were composed of round to polygonal neoplastic cells arranged in dense sheets or ill-defined fascicles. The neoplastic cells had locally invaded the myometrium and reached the subserosa, with lymphovascular invasion. Immunohistochemically, the neoplastic cell population was partially positive for CD10, an established marker of endometrial stromal sarcoma (ESS) in humans, with focal and diffuse nuclear immunopositivity for oestrogen and progesterone receptors and immunonegativity for desmin and α-smooth muscle actin. Based on these findings, the uterine tumour was diagnosed as ESS and was considered to correspond morphologically to high-grade ESS in humans. [Display omitted] [ABSTRACT FROM AUTHOR]

OBJECTIVE: In this study, we aimed to investigate the role of bone marrow-derived mesenchymal stem cells (BMSC) on the molecular mechanisms involved in the removal of endometrial adhesions and the implantation process in the experimentally-created Asherman syndrome model in rats. MATERIALS AND METHODS: An experimental model chemical agent was used. Culture medium (CM), only BMSC, 48-hour culture medium (Niche), and BMSC+ niche were used as therapy. Each group was divided into two subgroups, and changes in the endometrial tissue were investigated by histochemical and immunohistochemical staining. RESULTS: The results of the study show that BMSCs exhibit therapeutic properties in endometrial damage, increase endometrial thickness and vascularization, and contribute to the implantation of embryos by reducing fibrous areas. These results are promising for the prevention of Asherman-induced infertility. CONCLUSIONS: It has been shown that BMSC and Niche applications can be helpful in preventing adhesion molecules in the mechanisms that cause infertility. [ABSTRACT FROM AUTHOR]

Endometrial receptivity is largely determined by the immunophenotype of endometrium, especially uterine NK-cells (uNK). Immune component is directly involved in the formation of favourable microenvironment for the blastocyst implantation and placenta formation, but the way it changes during the maturation of endometrial tissue in healthy fertile women is still underexplored. The endometrium was collected from 47 healthy oocyte donors after controlled ovarian stimulation: 23 women on the day of oocytes retrieval (OR) and 24 women on the term of implantation window (IW). The OR group was analysed, published previously and used as a comparison group to show the dynamic of changes. Isolated endometrial lymphocytes and peripheral blood samples were stained with monoclonal antibodies and analysed according to the three-color flow cytometry protocol. The proportion of NK-cells (CD3−CD56+) in endometrium grew significantly in the implantation window compared to the oocytes retrieval day. NK-cells acquired a more differentiated phenotype from the day of OR until IW: the expression of CD8 and CD158a significantly increased, while the expression of HLA-DR significantly decreased. Significant correlations between peripheral blood and endometrial NK-cells were found in CD8 expression during OR and IW, CD335(p46)neg and CD335(p46)++ subsets during IW term. Immunophenotype of receptive endometrium forms due to the accumulation of uNK-cells, which actively proliferate, become mature, differentiative, and ready to meet the embryo. Endometrial immunophenotype is peculiar and specific but not autonomic and isolated. Differentiation (CD8 on NK-cells), and activity (p46 on NK-cells) of peripheral blood lymphocytes is reflected in endometrial lymphocytes profile, and therefore the research of peripheral blood immunophenotype is relevant. • Endometrial immunophenotype forms the receptivity and conditions for the implantation. • Endometrium matures with changes in the number and phenotype of uNK-cells. • On implantation window term, NK-cells actively proliferate and become differentiative. • Endometrial immunophenotype is specific but not autonomic and isolated. [ABSTRACT FROM AUTHOR]

Intrauterine adhesions (IUA) caused by endometrial injury are one of the main causes of female infertility. The current treatments for endometrial injury offer limited clinical benefits and cannot improve endometrial receptivity and pregnancy outcomes. Tissue engineering and regenerative medicine are considered potential solutions to address this concern and may offer effective treatment methods for the regeneration of injured human endometrium. Herein, we prepared an injectable hydrogel based on oxidized hyaluronic acid (HA-CHO) and hydrazide-grafted gelatin (Gel-ADH). The injectable hydrogel showed satisfactory biocompatibility when mixed with human umbilical cord mesenchymal stem cells (hUCMSCs). In an endometrial injury rat model, the treatment with hUCMSCs-loaded injectable hydrogel significantly enhanced the thickness of the endometrium and increased the abundance of blood vessels and glands in the injured endometrium compared to the control group. The hUCMSCs-loaded injectable hydrogel treatment significantly reduced endometrial fibrosis, decreased the expression of the pro-inflammatory factors (IL-1β and IL-6) and increased the expression of the anti-inflammatory factor (IL-10). This treatment induced endometrial VEGF expression by activating the MEK/ERK1/2 signaling pathway. Moreover, this treatment improved endometrial receptivity to the embryo and restored the embryo implantation rate similar to the sham group (48% in the sham group vs 46% in the treatment group), and this treatment achieved pregnancy and live birth in rats with endometrial injury. In addition, we also preliminarily validated the safety of this treatment in the maternal rats and fetuses. Collectively, our study showed that the hUCMSCs-loaded injectable hydrogel hold potential as an effective treatment strategy promoting rapid recovery of endometrial injury, and this hydrogel is a promising biomaterial for regenerative medicine applications. 1. Oxidized hyaluronic acid (HA-CHO)/hydrazide-grafted gelatin (Gel-ADH) hydrogel combined with human umbilical cord mesenchymal stem cells (hUCMSCs) are effective in improving the regeneration of endometrium in the endometrial injury rat model. 2. The hUCMSCs-loaded hydrogel treatment promotes the expression of endometrial VEGF through MEK/ERK1/2 signaling pathway and regulates the balance of inflammatory factors. 3. The embryo implantation and live birth rates restore to normal level in the endometrial injury rat model, and the hydrogel has no adverse effects on maternal rats, fetuses, and offspring development after the treatments. [Display omitted] [ABSTRACT FROM AUTHOR]

The mechanisms that govern fibroblast behavior during the vascular adaptations of the uterus at early pregnancy remain unknown. Anandamide, an endocannabinoid, binds to cannabinoid receptors (CBs), and regulates gestation and angiogenesis. Its tone is regulated by fatty acid amide hydrolase (FAAH) within the uterus. We investigated the role of anandamide in endometrial fibroblasts migration and whether anandamide modulates fibroblasts-endothelial crosstalk. T-hESC and EA.hy926 cell lines were used as models of endometrial stromal and endothelial cells, respectively. T-hESC were incubated with anandamide plus different agents. Migration was tested (wound healing assay and phalloidin staining). Protein expression and localization were studied by Western blot and immunofluorescence. To test fibroblast-endothelial crosstalk, EA.hy926 cells were incubated with fibroblast conditioned media obtained after T-hESC migration. Anandamide 1 nM increased T-hESC migration via CB1 and CB2. Cyclooxygenase-2 participated in anandamide-stimulated fibroblast migration. Prostaglandin F2alpha, and not prostaglandin E2, increased fibroblast wound closure. CB1, CB2, cyclooxygenase-2 and FAAH were expressed in T-hESC. Anandamide did not alter cyclooxygenase-2 localization but induced its cytoplasmic and nuclear expression through CB1 and CB2. URB-597, a FAAH selective inhibitor, also increased T-hESC migration via both CBs, and augmented cyclooxygenase-2 expression. Conditioned media from anandamide-induced T-hESC wound healing closure stimulated endothelial migration and did not alter their proliferation. Soluble factors from cyclooxygenase-2 were secreted by T-hESC and participated in T-hESC-induced EA.hy926 migration. Although anandamide-conditioned media augmented in EA.hy926 the expression of γH2AX, a marker of DNA damage, cyclooxygenase-2 was not involved in this effect. Our results provide novel evidence about an active role of anandamide on endometrial fibroblast behavior as a mechanism regulating uterine vascular adaptations in early gestation. [Display omitted] • Endometrial fibroblasts' role in early gestation vascular adaptations remains unknown. • A physiological level of anandamide induces the migration of endometrial fibroblasts. • Anandamide promotes endometrial fibroblast - endothelial cell interaction. • Cannabinoid receptors and cyclooxygenase-2 participate in anandamide-driven actions. • Anandamide might promote endometrial fibroblast participation in vascular remodeling. [ABSTRACT FROM AUTHOR]

Copyright of Cukurova Medical Journal / Çukurova Üniversitesi Tip Fakültesi Dergisi is the property of Cukurova University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The 2020 American Cancer Society guidelines preferred primary human papillomavirus (HPV) screening for cervical cancer prevention. Studies investigating the role of cytology in detection of cervical precancer/cancer have focused on high-grade squamous intraepithelial lesion (HSIL) or worse interpretations. Here, we have examined the significance of all those cytology results that require histologic follow-up as per the current management guidelines, regardless of the HPV test result. A database search (September 2010 to December 2019) retrieved cervical Papanicolaou tests with any of the following interpretations: ≥ atypical squamous cells – cannot exclude HSIL or low-grade squamous intraepithelial lesion, HSIL cannot be excluded, and ≥ atypical glandular cells, not otherwise specified and its subcategories. Of these, those with concurrent negative HPV test result were included for further analysis. For this cohort, relevant clinical history and histologic follow-up (within 1 year) were recorded. The study cohort comprised 763 patients. Of them, 586 (76.8%) patients had histologic follow-up: 53 (9.0%) had ≥ HSIL/adenocarcinoma in situ; of which, 43 (81.1%) had prior abnormal cytology/histology/not otherwise specified history and/or HPV positivity, and 66 (11.3%) had HPV-unassociated neoplasia; of which, 60 (90.9%) had a known diagnosis or clinical signs/symptoms of the disease. With widespread adoption of risk-based approach to management, the role of cytology, by itself, will likely diminish in the detection of HPV-associated lesions. Additional data regarding the role of cytology in the screening of patients with no/unknown/limited history and in the detection/management of HPV-independent lesions may be helpful for designing future screening guidelines. • The main objective of our study was to examine the significance of those cervical cytology results (in addition to ≥ high-grade squamous intraepithelial lesion), which require histologic follow-up regardless of the human papillomavirus (HPV) test result while taking into consideration the past history and clinical presentation of the patient. • Of a cohort of 763 patients that comprised 586 (76.8%) with follow-up, histologic high-grade squamous intraepithelial lesion/adenocarcinoma in situ or worse was detected in 53 (9.0%) and HPV-unassociated neoplasia in 66 (11.3%). • Majority of patients had an abnormal history/known diagnosis/clinical manifestations of the disease (81.1% in the HPV-associated group and 90.9% in the HPV-unassociated group). • The cervical Pap test detects a small subset of significant lesions of the female genital tract, independent of the HPV test. Additional data regarding the role of cytology in the screening of patients with no/unknown/limited history and in the detection/management of HPV-independent lesions may be helpful for designing future screening guidelines. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Primary fallopian tube neoplasms are usually rare, and they are the rarest of all female genital tract neoplasms. According to the WHO classification, papillomas, adenofibroma, cystadenoma, cystadenofibroma, and metaplastic papillary tumors belong to the group of benign tumor masses that arise from the fallopian tubes. Methods: In our case, during an abdominal hysterectomy in a 45-yearold woman suspicious of endometrial adenocarcinoma, a right tubal mass was incidentally found. Results: Microscopic findings revealed features of serous papillary adenofibroma. Serous papillary adenofibroma is a very rare tumor. Till date, only a few cases have been reported worldwide, more so in the presence of endometrial malignancy. Conclusion: Serous papillary adenofibroma is often an incidental finding; thus, it is important to gross the specimen minutely to look for any such finding in the adnexa to avoid missing out on such rare neoplasm. [ABSTRACT FROM AUTHOR]

Studying the underlying pathogenesis of disorders of the endometrium and of human pregnancy is challenging due to the lack of good in vivo and animal models. The development of organoid cultures has provided new opportunities to perform experiments in humans that recapitulate the in vivo situation. Endometrial organoids can be derived from tissues or menstrual fluid and respond robustly to ovarian hormones. Placental trophoblast organoids can only be generated from placentas under 9 weeks gestation. These assemble to form the structure of a placental villus. Modification of the culture conditions drives them to differentiate to the invading trophoblast that functions to transform the uterine spiral arteries. This process is critical for pregnancy success. These model systems will be transformative in understanding the biology of the female reproductive tract in health and disease. [ABSTRACT FROM AUTHOR]

Severe damage to the uterine endometrium, which results in scar formation and endometrial dysfunction, eventually leads to infertility or pregnancy-related complications. No effective therapeutic treatment is currently available for such injuries owing to the structural complexity, internal environment, and function of the uterus. Three-dimensional (3D) bio-printing to engineer biomimetic structural constructs provides a unique opportunity for tissue regeneration. Herein, using 3D extrusion-based bioprinting (EBB), we constructed a bilayer endometrial construct (EC) based on a sodium alginate-hyaluronic acid (Alg-HA) hydrogel for functional regeneration of the endometrium. The upper layer of the 3D bio-printed EC is a monolayer of endometrial epithelial cells (EECs), while the lower layer has a grid-like microstructure loaded with endometrial stromal cells (ESCs). In a partial full-thickness uterine excision rat model, our bilayer EC not only restored the morphology and structure of the endometrial wall (including organized luminal/ glandular epithelium, stroma, vasculature and the smooth muscle layer), but also significantly improved the reproductive outcome in the surgical area after implantation (75%, 12/16, p < 0.01). Therefore, repair of the uterine endometrium using the developed 3D bio-printed bilayer EC may represent an effective regenerative treatment for severe endometrial injury. Achieving structural and functional recovery of the endometrium following severe injury is still a challenge. Here, we designed a 3D bio-printed endometrial construct (EC) to mimic the native bilayer structure and cellular components of the endometrium. The bio-printed EC consists of a dense upper layer with endometrial epithelial cells and a lower layer with endometrial stromal cells. In particular, the 3D bio-printed EC significantly improved the reproductive outcome in the surgical area (75%, 12/16) compared to that of the cell-loaded non-printed group (12.5%, 2/16). This study demonstrates that a biomimetic bilayer construct can facilitate endometrial repair and regeneration. Therefore, an endometrial cells-loaded 3D-bioprinted EC is a promising therapeutic option for patients suffering from severe endometrial damage. [Display omitted] [ABSTRACT FROM AUTHOR]

Manufacturing of three-dimensional scaffolds with multiple levels of porosity are an advantage in tissue regeneration approaches to influence cell behavior. Three-dimensional scaffolds with surface roughness and intra-filament open porosity were successfully fabricated by additive manufacturing combined with chemical foaming and porogen leaching without the need of toxic solvents. The decomposition of sodium citrate, a chemical blowing agent, generated pores within the scaffold filaments, which were interconnected and opened to the external environment by leaching of a water-soluble sacrificial phase, as confirmed by micro-CT and buoyancy measurements. The additional porosity did not result in lower elastic modulus, but in higher strain at maximum load, i.e. scaffold ductility. Human mesenchymal stromal cells cultured for 24 h adhered in greater numbers on these scaffolds when compared to plain additive-manufactured ones, irrespectively of the scaffold pre-treatment method. Additionally, they showed a more spread and random morphology, which is known to influence cell fate. Cells cultured for a longer period exhibited enhanced metabolic activity while secreting higher osteogenic markers after 7 days in culture. Inspired by the function of hierarchical cellular structures in natural materials, this work elucidates the development of scaffolds with multiscale porosity by combining in-situ foaming and additive manufacturing, and successive porogen leaching. The resulting scaffolds displayed enhanced mechanical toughness and multiscale pore network interconnectivity, combined with early differentiation of adult mesenchymal stromal cells into the osteogenic lineage. [Display omitted] [ABSTRACT FROM AUTHOR]

Endometriosis is a common gynecological disease that affects women of reproductive age in which the uterine endometrium grows outside the uterus. Origin of the ectopic endometrium is thought to be the retrograde endometrium through the oviducts. However, factors that determine the adherence and proliferation of the ectopic endometrium have not been revealed. Importantly, systemic autoimmune diseases are considered a key factor in the endometriosis onset. Herein, we established a surgical endometriosis rodent model using autoimmune disease-prone MRL/MpJ-Faslpr/lpr (MRL/lpr) and MRL/+ mice to provide basic evidence of the relationship between autoimmune disease and endometriosis. Endometriosis lesions were successfully induced in two regions after transplanting uterine tissues from donor mice into the peritoneal cavity of recipient mice: the peritoneum or adipose tissue around the transplantation point (proximal lesions) and the gastrosplenic ligament or intestinal mesentery far from the transplantation site (distal lesions). Distal lesions were observed only in MRL/lpr mice, whereas endometriosis lesions showed no genotypeor region-related differences in the histology and distribution of sex hormone receptors and T cells. In contrast, transplanted uterine tissues in donor MRL/lpr mice exhibited a large infiltration of T cells in the lamina propria. Splenomegaly was more common in recipient than that in donor MRL/lpr mice. These results suggest that the infiltration of endogenous T cells in the endometrium alters the growth features of ectopic endometrium, possibly affecting the severity of endometriosis in patients with systemic autoimmune diseases. [ABSTRACT FROM AUTHOR]

Prolonged treatment with altrenogest in this case may have promoted fetal maceration; however, once altrenogest treatment was discontinued, the cervix still failed to dilate sufficiently to allow expulsion of the fetal bones due to the lack of fetal signalling (Long [5]). The cervix was gently manipulated until approximately 7.5 cm open and several bones were extracted from the uterine body through the cervix. At 414 days since LSD, the diagnosis of fetal maceration was confirmed by rectal palpation, ultrasonography of the uterus, and a digital examination of the cervix. Fetal maceration is the disintegration of a fetus that has died after the formation of fetal bones and has failed to abort, despite the presence of an open cervix (Purohit and Gaur [10]). [Extracted from the article]

Abnormal uterine bleeding in the perimenopause is a common gynaecological disorder and may affect 20–50 % of all women. It may be the first sign of premalignant or malignant disease. All women require assessment by means of pelvic ultrasound and an endometrial biopsy to exclude sinister pathology, identify other causes, and plan appropriate treatment. Pharmacological treatment includes antifibrinolytics, non-steroidal anti-inflammatories, combined hormonal contraception, cyclical progestogens and the levonorgestrel intrauterine system (LNG – IUS). Second line treatments may include endometrial ablation, uterine artery embolization, myomectomy or hysterectomy depending on the nature of the pathology. Minimal access techniques though the hysteroscopic, laparoscopic/robotic or vaginal route are increasingly used as the preferred surgical options. Novel treatments, either pharmacological or in the outpatient setting are likely to have a significant contribution in the future. [ABSTRACT FROM AUTHOR]

Despite recent advancements in reproductive medicine, recurrent implantation failure and habitual abortion remain ongoing issues. One of the most important aspects of successful implantation is the intricate immune response and regulation necessary for the acceptance of the hemiallogenic embryo. The most numerous immune cells in the decidua are uterine natural killer cells (uNK). Studies suggest that changes in the uNK count and physiology may be responsible for the aforementioned pathological conditions. Thus, testing for uNK may provide valuable insights into their pathogenesis. The study compared Pipelle endometrial sampling with conventional curettage to find out whether the less invasive Pipelle method is a viable alternative of tissue collection. Tissue samples from 14 patients obtained by both methods were examined. The average size of tissue samples obtained with Pipelle was 17 mm2, samples obtained with curettage had on average 34 mm2. Using immunohistochemical visualization of CD56 (NK cells) and granzyme B antigens (serine protease-expressing activation state of NK cells), it was found that the average total count of CD56 / mm2 was 115 for Pipelle and 120 for curettage, respectively. The study also proved a correlation between granzyme B positivity and identification of NK cells clusters. The results indicated that Pipelle endometrial sampling seems a suitable method of tissue harvesting for the purpose of uNK cells examination. Pipelle endometrial sampling is safe, cost-effective and can be performed on an outpatient basis without the need of anesthesia or analgesia. Several issues remain yet to be solved: how to standardize the subsequent uNK testing, how to interpret the results and finally yet importantly, how to use this knowledge in personalized treatment protocols. [ABSTRACT FROM AUTHOR]

Microorganisms and eukaryotic human cells coexist in synergistic relationships in nearly every niche of the human body. The female genital tract consisting of the vagina, uterus with its cervix and endometrium, uterine tubes and ovaries - harbors its own typical microbiota, which accounts for 9 % of the total bacterial population in females. To this organ system, we also assigned the microbiome of the placenta, which has not been studied much until now. Among the spectrum of microbial species, the female genital tract is mainly dominated by Lactobacillus species, which are considered to be one of the simplest yet most important microbial communities. However, this relationship between macro- and micro-organisms seems to have a number of physiological functions, e.g., the vaginal and cervical microbiota have unique impact on reproductive health. The aim of this review was to provide current view on female genital tract microbiota and its role in reproductive health. We describe in detail the association of vaginal or tubal epithelium with microbiota or the role of microbiota in normal placental function. [ABSTRACT FROM AUTHOR]

Impaired vascular growth resulting from reduced vascular endothelial growth factor (VEGF) in the epithelial tissue of the glands is a primary cause of thin endometrium. Inducing angiogenesis offers a possible therapeutic strategy for this condition. This study aimed to develop a novel drug delivery system using S75 lipoid loaded with VEGF for thin endometrium therapy. The formulation of PhytoSolve consisted of a combination of lipid S75, glycerol, and MCT oil, which was prepared utilizing a probe sonicator. Female NMRI mice (n=30) were divided into six groups: control, sham, thin endometrial model, VEGF treatment, PhytoSolve treatment, and VEGF / PhytoSolve treatment. A thin endometrial model was induced by injecting 95 % ethanol. After the treatment period, tissue samples were collected to assess the endometrial thickness—the mean particle size of the PhytoSolve formulation measured 67.57±7.07 nm. Approximately 40 % of the loaded VEGF was released within the first 24 hours, followed by a sustained release rate of 10–20 % daily. The PhytoSolve group containing VEGF exhibited significantly increased endometrial thickness compared to the VEGF group (P<0.05). S75 lipoid-based PhytoSolve loaded with VEGF effectively promoted blood vessel formation. The combination of PhytoSolve S75 and VEGF holds promise for developing a biocompatible drug delivery system with therapeutic potential for treating thin endometrium and various other biomedical applications. [Display omitted] • S75 lipoid-based PhytoSolve loaded with VEGF effectively promoted blood vessel formation. • The PhytoSolve group containing VEGF exhibited significantly increased endometrial thickness compared to the VEGF group. • The PhytoSolve formulation increases the shelf life of VEGF in the blood serum. [ABSTRACT FROM AUTHOR]

• Characterization of the equine endometrial microbiome in anestrus using 16S rRNA. • Mare endometrial microbiome in anestrus has high diversity, richness and abundance. • Significant differences between endometrial microbiome of anestrus and estrus mares. The equine uterus is highly interrogated during estrus prior to breeding and establishing pregnancy. Many studies in mares have been performed during estrus under the influence of high estrogen concentrations, including the equine estrual microbiome. To date, it is unknown how the uterine microbiome of the mare is influenced by cyclicity; while, the equine vaginal microbiome is stable throughout the estrous cycle. We hypothesized that differences would exist between the equine endometrial microbiome of mares in estrus and anestrus. The aim of this study was two-fold: to characterize the resident endometrial microbiome of healthy mares during anestrus and to compare this with estrus. Double-guarded endometrial swabs were taken from healthy mares during estrus (n = 16) and in the following non-breeding season during anestrus (n = 8). Microbial population was identified using 16S rRNA sequencing. Our results suggest that the equine uterine microbiome in estrus has a low diversity and low richness, while during anestrus, a higher diversity and higher richness were seen compared to estrus. Despite this difference, both the estrus and anestrus endometrial microbiome were dominated by Proteobacteria, Firmicutes, and Bacteroidota. The composition of the microbial community between anestrus and estrus was significantly different. This may be explained by the difference in the composition of the endometrial immune milieu based on the stage of the cycle. Further research investigating the function of the equine endometrial microbiome and dynamics changes within the uterine environment is required. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Detection of endometrial cancer (EC) is crucial in pre-operative EC management. The study aimed at determining the most reliable sequence in magnetic resonance imaging (MRI) evaluation at the EC. Different sequences were compared using histopathological results as the gold standard. PATIENTS AND METHODS: In this retrospective study, 62 women diagnosed with EC were examined using 3 Tesla MR and post-hysterectomy histopathological examination. The MRI protocol included diffusion-weighted imaging (DWI), T2 weighted images, Dynamic Contrast T1 weighted images, and ZOOMit DWI. Apparent diffusion coefficient (ADC) maps were also obtained. ADC maps were calculated for both DWI and ZOOMit DWI. All serial images were analyzed by endometrial distance to account for myometrial invasion and tumor size. All sequences and histopathological results were compared using the paired sample t-test. RESULTS: In all 32 women, post-hysterectomy histopathological confirmation was obtained. Mean myometrial invasion values were not significantly different after comparing DWI, ZOOM it DWI, and Dynamic contrast enhancement (DCE)-T1WI (p=0.054, p=0.039). The first strong correlation was found between DWI and ZOOMit DWI (0.943). The second was between ZOOMit DWI and DCE-T1 WI (0.949). Comparing each set of sequences, no statistically significant differences in tumor size (p > 0.05) were found. Also, no statistically significant differences between images and histopathological size were found. The ADC values of ZOOMit DWI indicated that this method detected significant differences between EC histological subtypes. CONCLUSIONS: Each sequence is essential and valuable, whereas priorities may vary depending on the desired information. The most valuable sequences for the myometrial invasion were ZOOMit and conventional DWI. T2WI and DCE T1 WI were more valuable sequences the size of EC. [ABSTRACT FROM AUTHOR]

HHUA endometrial adenocarcinoma cells aggregated into spheroids when cultured on collagen type I gels. 12-O-Tetradecanoylphorbol 13-acetate, a PKC activator, disassembled the spheroids through epithelial-mesenchymal transition and increased their proliferation rate, while inducing cell death under monolayer culture conditions. These unusual behaviors of endometrial epithelial cells with collagen fibers could be a target for the treatment of some endometrial diseases. [ABSTRACT FROM AUTHOR]

Aims: Transvaginal sonography (TVS) is not applicable for evaluating the endometrium in some cases with abnormal uterine bleeding (AUB) such as virgin women. The aim of the present study was to investigate the diagnostic value of transrectal sonography (TRS), as a non-invasive alternative for TVS, among women with AUB. Methods: In this cross-sectional study, 40 women over 40 years of age with AUB first underwent TRS and then TVS. Endometrial biopsy was also performed as a gold standard method to evaluate endometrial pathologies. The findings of the two endometrial ultrasound methods were compared with the biopsy results. Also, the findings of the two methods were compared in terms of the agreement on other uterine markers and adnexal findings. Results: There was a high agreement between the findings of TVS and TRS for uterine size, endometrial thickness and homogeneity, endomyometrial junction, myometrial homogeneity, uterine lesions, uterine lesions size, ovarian size and ovarian echogenicity. When comparing the results of these two methods with biopsy findings, sensitivity, specificity as well as positive and negative predictive values of both methods were similar (82%, 100%, 100%, and 0%, respectively). Conclusion: When it is not possible to use TVS in women with AUB, TRS is a suitable, non-invasive and inexpensive alternative method for evaluating the endometrium and other genital organs. [ABSTRACT FROM AUTHOR]

Sampling of the endometrium, via biopsy or dilation and curettage, is an important diagnostic tool in a wide variety of clinical scenarios, ranging from infertility and abnormal uterine bleeding to cancer surveillance in high-risk populations. This review describes the most common methods for endometrial sampling used currently and discusses the issue of specimen adequacy from an evidence-based perspective. It also focuses on select benign conditions involving the endometrium in the setting of abnormal uterine bleeding, ranging from anatomic/structural lesions to patterns indicative of a dysfunctional menstrual cycle. The topic of endometrial sampling evaluation in the context of recurrent pregnancy loss is also discussed, with insights on documentation of endometrial changes during the ovulatory phase and the diagnosis of endometritis. [ABSTRACT FROM AUTHOR]

Human reproductive success relies on the intricate interplay between the developing embryo and the maternal endometrium. These highly-coordinated interactions facilitate implantation, setting in motion a series of developmental programs to establish a sustained fetal-maternal interface. Understanding endometrial function and the early human embryo-maternal dialogue is thus an important prerequisite for refining clinical approaches to alleviate implantation failure, early pregnancy loss and other obstetric complications. Yet, many mediators of implantation remain elusive. Driven by endocrine factors, interactions at the embryo-maternal interface are tightly regulated and highly complex. Coupled to the inaccessibility of the in vivo environment and scarcity of research material, studying human implantation remains exceptionally challenging. Nevertheless, the field continues to gain momentum. Cutting-edge omics technologies and high-resolution imaging have revealed important structural and functional insights into endometrial biology, while emerging bioengineering tools are enhancing our ability to model the synergies and individual features of the embryo-maternal environment. Novel in vitro platforms using human cells and embryos are considerably more accessible and easier to manipulate compared to in vivo approaches, enhancing our ability to capture specific stages of implantation. This review aims to showcase current and emerging technologies used to study human endometrial biology and the early embryo-maternal interface, including single cell omics approaches, bioengineered endometrial models and embryo-endometrium co-culture platforms. We highlight the value of these approaches and provide our perspective on the current challenges faced by the field. Recognizing the physiological scope of these emerging technologies will be key for utilizing their full potential and driving future innovation. [ABSTRACT FROM AUTHOR]

Correct establishment of the placenta is critical to the success of a pregnancy, but many of the key events take place during or shortly after implantation and are inaccessible for study. This inaccessibility, coupled with the lack of a suitable preclinical animal model, means that knowledge of human early placental development and function is extremely limited. Hence, the first trimester is often referred to as the 'black box' of pregnancy. However, recent advances in the derivation of trophoblast stem cells and organoid cultures of the trophoblast and endometrium are opening new opportunities for basic and translational research, providing for the first time cells that faithfully replicate their tissue of origin and proliferate and differentiate in culture in a stable and reproducible manner. These cells are valuable new tools for investigating cell-lineage differentiation and maternal-fetal interactions, but become even more powerful when combined with advances in bioengineering, microfabrication and microfluidic technologies. Assembloids of the endometrium comprising various cell types as model systems to investigate events at implantation, and placentas-on-a-chip for the study of nutrient transfer or drug screening are just two examples. This is a rapidly advancing field that may usher in more personalised approaches to infertility and pregnancy complications. Many of the developments are still at the proof-of-principle phase, but with continued refinement they are likely to shed important light on events that are fundamental to our reproduction as individuals and as a species, yet for ethical reasons are hidden from view. [ABSTRACT FROM AUTHOR]

Introduction: The uterus and placenta transport water during pregnancy recognition signaling, conceptus implantation, and placental development/placentation. This is likely influenced by aquaporins (AQPs) in the reproductive tract. This study determined mRNA and cell-type specific expression of AQP 1, 5, 8, and 9 proteins in the porcine uterus and placenta.Methods: Porcine uteri and Chorioallantois were subjected to real-time PCR and immunofluorescence microscopy.Results: AQP1 mRNA was maximal by Day 25 in endometrium and remained stable thereafter. AQP1 mRNA did not change in chorioallantois. AQP1 protein localized to erythrocytes and endothelium of the endometrium and allantois, and to smooth muscle of the myometrium. AQP5 protein localized to apical and lateral surfaces of the chorionic epithelia of areolae, but mRNA did not change in chorioallantois. AQP8 mRNA was high in the endometrium from Days 15 through 60 of gestation, and protein localized to multiple cell types within the endometrium and chorioallantois. AQP9 mRNA was highest in the endometrium on Days 10, 12 and 25, but did not change in the chorioallantois. AQP9 protein localized to the apical surface of endometrial luminal epithelial cells during early pregnancy, with a shift towards the basal surface later. AQP9 protein was observed in the allantoic epithelium.Discussion: Results reveal pigs can potentially use AQP1, AQP5, AQP8, and AQP9 to transport water from the endometrial bloodstream to the allantoic bloodstream or allantoic fluid. The reverse is also possible and may explain the mechanism for changing volumes of allantoic fluid and hydration of allantoic connective tissues during pregnancy. [ABSTRACT FROM AUTHOR]

Premature birth and its associated complications are one of the biggest global health problems, since there is currently no effective screening method in clinical practice to accurately identify the true Preterm Birth (PTB) from the false threatened ones. Despite the high prevalence of PTB in multiple gestation (MG) women which amounted up to 60%, in the literature there is any work about their uterine myoelectric activities in vivo system. Electrohysterography (EHG) has been emerged as an alternative technique for predicting PTB in single gestation (SG) women. The aim of this study was to characterize and compare the uterine myoelectrical activity in vivo system of SG and MG women in regular check-ups, to provide the basis for early detection and prevention of preterm labour in MG. A prospective observational cohort study was conducted on 31 SG and 18 MG women between the 28th and 32th WoG who underwent regular check-ups in the Polytechnic and University Hospital La Fe (Valencia, Spain). The 30-minute bipolar recording was filtered in the 0.1-4 Hz bandwidth and downsampled to 20 Hz. Signal analysis was performed in 120-second moving windows with 50% overlap, after removing artefacts by a double- blind expert process. A set of 8 temporal, spectral and non-linear parameters were calculated: root mean square (RMS), kurtosis of the Hilbert envelope (KHE), median frequency (MDF), H/L ratio, and sample entropy (SampEn) and bubble entropy (BubbEn) calculated in the whole bandwidth (WBW) and the fast wave high (FWH). The 10th, 50th and 90th percentiles of all windows analysed were calculated to obtain representative values of the recordings. For each parameter and percentile, statistically significant differences between the SG and MG groups and their statistical power (SP) were analysed to determine both the existence of an effect and substantive significance, respectively. In comparison to SG, MG EHG exhibited significant higher impulsiveness and higher predictability than SG which was reflected in the KHE (SP 10 = 85.2, p 10 < 0.001) and entropy measures (SampEn FWH: SP 50 = 62.0, p 50 = 0.0.016; SP 90 = 52.5, p 90 = 0.059. BubbEn FWH: SP 50 = 75.2, p 50 < 0.001; SP 90 = 60.3, p 90 = 0.002), suggesting an accelerated evolution of uterine electrophysiological condition. In addition, several EHG parameters were found to significantly correlate with foetal weight such as amplitude (RMS: r 90 = 0.311, p 90 = 0.006), signal impulsiveness (KHE: r 10 = 0.311, p 10 = 0.006) and entropy measures (SampEn FWH: r 50 = −0.317, p 50 = 0.005*; r 90 = −0.279, p 90 = 0.013*. BubbEn FWH: r 50 = −0.370, p 50 = 0.001*; r 90 = −0.313, p 90 = 0.005*), suggesting an electromechanical coupling between uterine overdistension and contractile activity in vivo system. In comparison to SG women, MG showed higher impulsiveness and predictability in early third gestational trimester, as reflected in KHE, SampEn and BubbEn, respectively. We found similar cell excitability between SG and MG women far from delivery. In addition, we confirmed the relationship between uterine overdistension and surface myoelectric activity, revealing the electromechanical coupling pathway in uterine smooth muscle. Therefore, contextualized EHG-biomarkers would provide valuable information for early detection of PTB risk, which would allow clinicians better PTB management through personalised therapeutic interventions. • EHG features in multiple pregnancy differ from singleton ones in third trimester. • Multiple pregnancies show greater impulsivity and predictability than singletons. • Uterine overdistension may cause accelerated biophysical process toward labour. • Overdistension should be considered as a risk factor for preterm birth prediction. [ABSTRACT FROM AUTHOR]

Lipid metabolism plays an important role in early pregnancy, but its effects on decidualization are poorly understood. Fatty acids (FAs) must be esterified by fatty acyl-CoA synthetases to form biologically active acyl-CoA in order to enter the anabolic and/or catabolic pathway. Long-chain acyl-CoA synthetase 4 (ACSL4) is associated with female reproduction. However, whether it is involved in decidualization is unknown. The expression of ACSL4 in human and mouse endometrium was detected by immunohistochemistry. ACSL4 levels were regulated by the overexpression of ACSL4 plasmid or ACSL4 siRNA, and the effects of ACSL4 on decidualization markers and morphology of endometrial stromal cells (ESCs) were clarified. A pregnant mouse model was established to determine the effect of ACSL4 on the implantation efficiency of mouse embryos. Modulation of ACSL4 detects lipid anabolism and catabolism. Through examining the expression level of ACSL4 in human endometrial tissues during proliferative and secretory phases, we found that ACSL4 was highly expressed during the secretory phase. Knockdown of ACSL4 suppressed decidualization and inhibited the mesenchymal-to-epithelial transition induced by MPA and db-cAMP in ESCs. Further, the knockdown of ACSL4 reduced the efficiency of embryo implantation in pregnant mice. Downregulation of ACSL4 inhibited FA β-oxidation and lipid droplet accumulation during decidualization. Interestingly, pharmacological and genetic inhibition of lipid droplet synthesis did not affect FA β-oxidation and decidualization, while the pharmacological and genetic inhibition of FA β-oxidation increased lipid droplet accumulation and inhibited decidualization. In addition, inhibition of β-oxidation was found to attenuate the promotion of decidualization by the upregulation of ACSL4. The decidualization damage caused by ACSL4 knockdown could be reversed by activating β-oxidation. Our findings suggest that ACSL4 promotes endometrial decidualization by activating the β-oxidation pathway. This study provides interesting insights into our understanding of the mechanisms regulating lipid metabolism during decidualization. • ACSL4 is essential for the decidualization of the endometrium. • Lipid droplets accumulated and β-oxidation was enhanced during decidualization. • Inhibition of β-oxidation enhances lipid droplet synthesis and impairs decidualization. • ACSL4 promotes decidualization by activating β-oxidation. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Endocrine Society classified patients with serum 25-hydroxyvitamin D [25(OH)D] levels below 20 ng/ml as deficiency, 20-30 ng/ml as insufficiency, and >30 ng/ml as replete. This study was planned to investigate the relationship between serum vitamin D level and homeobox 10 mRNA expression in women with polycystic ovary syndrome (PCOS). PATIENTS AND METHODS: Thirty women with PCOS who failed the first IVF/ICSI attempt and were decided to have endometrial injury before second attempt were included in the study. Before the endometrial injury, the serum vitamin D levels of the women were measured, and they were divided into three equal groups as proposed by the Endocrine Society. Group 1 consisted of vitamin D deficient women (<20 ng/mL), Group 2 consisted of vitamin D insufficient women (20-30 ng/mL), and Group 3 consisted of vitamin D replete women (>30 ng/mL). Women in each group were injured with a Pipelle cannula during mid-luteal phase. Endometrial samples collected during injury were analyzed for HOXA10 mRNA expression by RT-PCR and correlated with serum vitamin D level. RESULTS: When analyzing the results according to different vitamin D thresholds, as proposed by the Endocrine Society, HOXA10 mRNA expression was comparable between vitamin D deficient and vitamin D insufficient women. The HOXA10 mRNA expression of vitamin D replete women(Group 3) was found to be higher than both vitamin D deficient (Group 1) and vitamin D insufficient women (Group 2). HOXA10 mRNA expression of the women in Group 3 was 3.3-fold higher than Group 1 and 2.6-fold higher than Group 2. HOXA10 mRNA expression was correlated to the levels of vitamin D in the Group 3 (r=0.655, p=0.02). There was no significant correlation between serum vitamin D levels and endometrial HOXA10 mRNA expression of women in both Group 1 (r=0.343, p=0.06) and Group 2 (r=0.456, p=0.08). CONCLUSIONS: Endometrium of women with PCOS with sufficient serum vitamin D levels express significantly higher HOXA10 mRNA than patients with low serum vitamin D levels. [ABSTRACT FROM AUTHOR]

Studies in the gravid rat model revealed a key role for the corpus luteal hormone, relaxin, in the maternal circulatory changes of early pregnancy epitomized by profound systemic vasodilation and increased arterial compliance. To determine whether the corpus luteum may play a similar role in human pregnancy, women who conceived by in vitro fertilization were studied. Implementation of artificial (programmed) cycles for embryo transfers, which precluded the formation of a corpus luteum, was associated with notable attenuation of the gestational rise in cardiac output and fall in carotid-femoral pulse wave velocity (reflecting impairment of arterial dilation and increased compliance, respectively) and deficiencies in other cardiovascular changes normally observed during the first trimester. Cardiac output and carotid-femoral pulse wave velocity were restored after the first trimester of pregnancy, consistent with rescue by placental vasodilators, such as placental growth factor. In addition, a potential role of corpus luteal factors in reducing the risk of developing preeclampsia was hypothesized. In most single and multiple center, prospective and retrospective cohort (and registry) studies, the risk of developing preeclampsia and preeclampsia with severe features was increased specifically in women undergoing autologous frozen embryo transfer in artificial cycles without the formation of a corpus luteum relative to natural, modified natural, stimulated, or controlled ovarian stimulation cycles and spontaneous pregnancies-all associated with the formation of at least 1 corpus luteum. Taken together, these observational studies are sufficiently compelling to warrant randomized clinical trials comparing preeclampsia risk in autologous frozen embryo transfer in natural vs artificial cycles. Impaired endometrial function because of suboptimal hormonal administration is an alternative but not mutually exclusive explanation for increased preeclampsia risk in autologous frozen embryo transfer in artificial cycles. Potential mechanisms by which the corpus luteum may reduce the risk of developing preeclampsia and whether autologous frozen embryo transfer in artificial cycles is associated with increased risk of preterm preeclampsia, term preeclampsia, or both are discussed. Last, suggestions for future investigations are noted. [ABSTRACT FROM AUTHOR]

Ultrasound is a key non-invasive imaging modality in gynaecology, and its widespread use and availability in past three decades has drastically changed clinical practice. This article provides an overview of the contribution of ultrasound examination to the evaluation of gynaecological conditions by summarizing the basic physics of ultrasound, and ultrasound features. [ABSTRACT FROM AUTHOR]

Uterine spiral artery remodeling is one of the key maternal adaptations of pregnancy, allowing delivery of the large volumes of maternal blood required for both placental and fetal growth. Failure of this process is associated with obstetric complications including preeclampsia, fetal growth restriction and miscarriage. Spiral artery remodeling is characterized by loss of the musculoelastic wall which is replaced by fibrinoid and intramural extravillous trophoblast cells (EVT). In recent years attention has focused on the initial stages of spiral artery remodeling which include separation of the vascular smooth muscle cells (VSMCs) and their phenotypic switch to a more synthetic phenotype, facilitating their migration away from the vessel wall. However, less is known about the final fate of the VSMCs. In vitro studies suggested that EVT could induce VSMC apoptosis, though VSMC apoptosis is not seen within the wall of the spiral arteries undergoing remodeling. However, apoptotic VSMCs have been observed amongst those cells which had migrated away from the vessel wall. This review article gives a brief overview of the current state of knowledge of the processes involved in spiral artery remodeling, and then concentrates on the mechanisms involved in VSMC apoptosis, drawing on knowledge from other vascular beds. [ABSTRACT FROM AUTHOR]

Preeclampsia is a major obstetrical complication with short- and long-term life-threatening consequences for both mother and child. Shallow cytotrophoblast invasion through the uterine decidua into the spiral arteries is implicated in the pathogenesis of preeclampsia, although the cause of deficient arterial invasion remains unknown. Research that is focused on the "soil"-the maternal decidua-highlights the importance of this poorly understood but influential uterine layer. Decidualization of endometrial cells regulates embryo invasion, which is essential for spiral artery remodeling and establishing the maternal-fetal interface. Exploration of the association between impaired decidualization and preeclampsia revealed suboptimal endometrial maturation and uterine natural killer cells present in the decidua before preeclampsia development. Furthermore, decidualization defects in the endometrium of women with severe preeclampsia, characterized by impaired cytotrophoblast invasion, were detected at the time of delivery and persisted 5 years after the affected pregnancy. Recently, a maternal deficiency of annexin A2 expression was found to influence aberrant decidualization and shallow cytotrophoblast invasion, suggesting that decidualization resistance, which is a defective endometrial cell differentiation during the menstrual cycle, could underlie shallow trophoblast invasion and the poor establishment of the maternal-fetal interface. Based on these findings, the transcriptional signature in the endometrium that promotes decidualization deficiency could be detected before (or after) conception. This would serve to identify women at risk of developing severe preeclampsia and aid the development of therapies focused on improving decidualization, perhaps also preventing severe preeclampsia. Here, we discuss decidualization deficiency as a contributor to the pathogenesis of pregnancy disorders with particular attention to severe preeclampsia. We also review current diagnostic strategies and discuss future directions in diagnostic methods based on decidualization. [ABSTRACT FROM AUTHOR]

A 14-y-old Miniature Pinscher bitch was admitted to a veterinary clinic because of inappetence and a distended abdomen; ultrasound examination revealed a fluid-filled uterus with a single 1-cm hyperechoic nodule in its lumen. Ovariohysterectomy was performed. Grossly, the uterine horns were distended irregularly and asymmetrically, and the uterine lumen contained 200–300 mL of brown watery fluid. A single white polypoid 0.9-cm diameter nodule was present at the site of the distended uterine horn and arose from the endometrium with a narrow stalk. Histologically, the polyp consisted of dense, smooth muscle fascicles admixed with glandular components; its surface was covered by simple cuboidal epithelium with areas of squamous metaplasia. The myomatous cells expressed the myogenic markers smooth muscle actin and desmin. We interpreted the mass as an adenomyomatous uterine polyp, which is a rare variant of an endometrial polyp. [ABSTRACT FROM AUTHOR]

Osseous metaplasia of the endometrium is defined by the presence of mature or immature bone tissue in the endometrium. Most of the cases are associated with secondary infertility after abortion, chronic endometritis, or the presence of foreign bodies in the endometrium. Some cases are asymptomatic; others have menstrual abnormalities such as menorrhagia or oligomenorrhea. Osseous metaplasia is mostly seen after recurrent abortions. Removing the bone tissue helps spontaneous conception. Intrauterine hyperechogenic lesion, suggesting calcification in transvaginal ultrasonography, creates suspicion in diagnosis. Here, we present a patient who underwent dilatation and curettage procedure following a missed abortion, and osseous metaplasia of endometrium was radiologically detected at a 1‑month follow‑up examination. White bony material was shown in the uterine cavity with hysteroscopy. The lesion was treated by hysteroscopic removal without any complications. Histology confirmed the diagnosis of endometrial osseous metaplasia. Thus, hysteroscopy was effective in the diagnosis and treatment of endometrial osseous metaplasia. [ABSTRACT FROM AUTHOR]

Introduction: In preeclampsia (PE), human decidua mesenchymal stromal cells (hDMSCs) are exposed to abnormally high levels of oxidative stress and inflammatory factors circulating in the maternal blood. MicroRNAs (miRNAs) have been shown to have a significant impact on the differentiation, maturation and function of mesenchymal stromal cells (MSCs). Our aim in the present study is firstly to investigate differentially expressed miRNA levels to be used as a biomarker in the early detection of PE and secondly to investigate whether those differentially expressed miRNAs in hDMSCs have an effect on the pathogenesis of PE.Methods: This study covers miRNA expression analysis of hDMSCs from 7 PE patient and 7 healthy pregnant women and is a preliminary study to investigate putative biomarkers. After cell culture and cell sorting, total RNA including miRNAs were isolated from hDMSCs. Let-7b-3p, let-7f-1-3p, miR-191-3p, miR-550a-5p, miR-33b-3p and miR-425-3p were used for miRNA analysis and U6 snRNA was used for normalization of the samples. MiRNA analysis was performed by droplet digital polymerase chain reaction (ddPCR) method and obtained results were evaluated statistically.Results: As a result of the analysis, it was observed that the levels of hsa-miR-33b-3p significantly (AUC: 0.93, p = 0.04, fold change: 4.5) increased in hDMSC of PE patients compared to healthy controls. However, let-7b-3p, let-7f-1-3p, miR-191-3p, miR-550a-5p, and miR-425-3p were not considered as significant because they did not meet the p < 0,05 requirement.Discussion: Within the scope of the study, it is predicted that miR-33b-3p (p = 0.004, AUC = 0.93) can be used as a biomarker in detecting PE. [ABSTRACT FROM AUTHOR]